Document Detail


Natural history of dural arteriovenous shunts.
MedLine Citation:
PMID:  18388337     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Dural arteriovenous shunts with cortical venous reflux or drainage may cause neurological symptoms and death with or without intracranial hemorrhage. Present knowledge about the natural history of these lesions is limited, however. We investigated the incidences of intracranial hemorrhage, progressive dementia syndrome, and death in patients diagnosed in our neurovascular center. METHODS: We evaluated the records of 85 patients with dural arteriovenous shunts with cortical venous drainage or reflux hospitalized in our institution from 1978 to 2007. The annual incidences of intracranial hemorrhage, progressive dementia syndrome, and death were calculated. RESULTS: Fifty-three patients did not have an intracranial hemorrhage as the presenting event. One of these patients bled after diagnosis. Thirty-two patients had an intracranial hemorrhage as the presenting event. Three patients bled after diagnosis. One of these patients died. Apart from deficits caused by hemorrhage, no patient reported adverse neurological symptoms. In patients presenting with an intracranial hemorrhage the annual risk for hemorrhage is approximately 7.4% and in those not presenting with a hemorrhage it is approximately 1.5%. CONCLUSIONS: The risk of intracranial hemorrhage from a dural arteriovenous shunt with cortical venous drainage is most likely smaller than previously proposed. Presentation with hemorrhage is a risk factor for hemorrhage. The risks of developing neurological symptoms not related to hemorrhage are also less than previously reported.
Authors:
Michael Söderman; Ladislav Pavic; Göran Edner; Staffan Holmin; Tommy Andersson
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Publication Detail:
Type:  Journal Article     Date:  2008-04-03
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  39     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-28     Completed Date:  2008-07-03     Revised Date:  2009-04-28    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1735-9     Citation Subset:  IM    
Affiliation:
Department of Neuroradiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. michael.soderman@karolinska.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Central Nervous System Vascular Malformations / epidemiology*,  physiopathology
Cerebral Arteries / abnormalities,  physiopathology
Cerebral Veins / abnormalities,  physiopathology
Cerebrovascular Circulation / physiology
Comorbidity
Cranial Sinuses / abnormalities,  physiopathology
Dementia / epidemiology*,  physiopathology
Disease Progression
Female
Humans
Intracranial Hemorrhages / epidemiology*,  physiopathology
Magnetic Resonance Imaging
Male
Middle Aged
Predictive Value of Tests
Prognosis
Prospective Studies
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
Comments/Corrections
Comment In:
Stroke. 2009 May;40(5):e412; author reply e413-4   [PMID:  19342606 ]

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