Rupture Risk of Cerebral Arteriovenous Malformations During Pregnancy and Puerperium: A Single-Center Experience and Pooled Data Analysis

Cerebral arteriovenous malformation rupture in pregnancy

“…Zhu et al found in their single-centre case series a haemorrhage risk of 5.59% during pregnancy and puerperium and a 2.52% risk in the non-pregnant period 4. Looking specifically at the North American population, Porras et al and Gross et al found an increased cAVM haemorrhage risk in pregnancy: 5.7% versus 1.3% and 8.1% versus 1.1%, respectively 4 13 14. cAVMs are typically identified by CT/CTA head or MRI brain as these studies are more readily available and are non-invasive in comparison with catheter-based cerebral angiogram.…”

“…With respect to pregnancy, Liu et al report no change in risk of haemorrhage during pregnancy (3.1%) in a retrospective review of 979 women diagnosed with a cAVM 12. Zhu et al found in their single-centre case series a haemorrhage risk of 5.59% during pregnancy and puerperium and a 2.52% risk in the non-pregnant period 4. Looking specifically at the North American population, Porras et al and Gross et al found an increased cAVM haemorrhage risk in pregnancy: 5.7% versus 1.3% and 8.1% versus 1.1%, respectively 4 13 14.…”

“…Impact of pregnancy on cAVM rupture is controversial due to inconsistency among rates reported in the literature 4. Factors such as increasing age, initial haemorrhagic cAVM presentation, deep brain location, presence of associated aneurysms, deep venous drainage, small nidus size and high feeding artery pressure have been determined to be independent predictors of cAVM haemorrhage 7 11.…”

“…Cerebral arteriovenous malformations (cAVMs) are uncommon congenital vascular lesions, occurring in approximately 0.01%–0.5% of the population 1. The annual haemorrhage rate of cAVMs is about 2%–4% per year 2–4. Goldberg et al found in their systematic review an average annualised haemorrhage rate of 2.2% for previously unruptured cAVM and 4.3% for cAVMs that present with haemorrhage 5.…”

Ruptured Thoracolumbar Perimedullary Arteriovenous Fistula during Pregnancy Complicated by Cerebral Subarachnoid Hemorrhage and Brainstem Hematoma: A Case Report

“…None of the above mentioned cranial SAH with clinically silent thoracolumbar sAVF manifested during pregnancy. It has been postulated that physiological hormonal changes associated with pregnancy, along with compression of venous outflow and augmented intravascular volume make the spinal malformation particularly susceptible to clinical manifestations due to vessel rupture or venous congestion [ 19 ]. The risk of clinical deterioration decreases after delivery and some spinal AVFs may even spontaneously regress [ 20 , 21 ].…”