Venous angiomas: An underestimated cause of intracranial hemorrhage

Malik, Ghaus M.; Morgan, Jay K.; Boulos, Roushdy; Ausman, James I.

doi:10.1016/0090-3019(88)90197-8

Cited by 101 publications

(42 citation statements)

References 23 publications

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“…It was impossible to allocate a mode of presentation to 23% of the participants, but none of them had symptomatic hemorrhage. Although 3 of the 15 published studies reported an unexpectedly high prevalence of intracranial hemorrhage due to DVAs (Table 1), 11,22,27 their findings may be explained by selection, investigation, and reporting biases (for example, none of them used MRI and consequently did not report whether there were associated CMs and one of them included DVAs with arterial components 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…Six of these studies did not match the selection criteria; one did not contain any information on clinical presentation or clinical course, 17 4 were earlier, smaller versions of studies included in this systematic review, 18 -21 and one was a precursor of the SIVMS data presented in this article. 7 The 15 remaining papers, [11][12][13]16,[22][23][24][25][26][27][28][29][30][31][32] reported on the clinical presentation of DVAs (Table 1), and 8 of these studies also described their clinical course (Table 3). 12,13,16,22,24,26,28,29 The largest study included 100 participants 12 ; 6 (40%) studies of clinical presentation 12,[23][24][25][26][27] ; and 3 (38%) studies of clinical course 12,24,26 included Ն50 participants.…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…Fifteen studies reported the clinical presentation of a total of 714 participants (Table 1), [11][12][13]16,[22][23][24][25][26][27][28][29][30][31][32] of whom at least 10% had an associated CM. Some studies were not generalizable because, for example, they were restricted to cerebellar DVAs 29 or included DVAs that had arterial components.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…10 The frequencies of these manifestations at the time of DVA diagnosis and during untreated follow-up after diagnosis (clinical course) appear to vary between studies. Whether to treat DVAs 11 or not [12][13][14] is still debated. However, it is generally agreed that resection of a functionally draining DVA carries a high risk of cerebral infarction and consequent morbidity.…”

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confidence: 99%

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The Presentation and Clinical Course of Intracranial Developmental Venous Anomalies in Adults

Hon

Bhattacharya

Counsell

et al. 2009

Stroke

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on behalf of the SIVMS Collaborators* Background and Purpose-Reported risks of hemorrhage from intracranial developmental venous anomalies (DVAs) vary, so we investigated this in a systematic review and population-based study. Methods-We systematically reviewed the literature (Ovid Medline and Embase to November 7, 2007) and selected studies of Ն20 participants with Ն1 DVA(s) that described their clinical presentation and/or their clinical course over a specified follow-up period. We also identified every adult first diagnosed with a DVA in Scotland from 1999 to 2003 and followed them in a prospective, population-based study. Results-Of 2068 articles detected by the literature search, 15 met our inclusion criteria and described clinical presentation, 8 of which also described the clinical course of DVAs. In the 15 studies of 714 people first presenting with a DVA, 61% were incidental findings, the mode of presentation was unclear in 23%, 6% presented with nonhemorrhagic focal neurological deficit, 6% had caused symptomatic hemorrhage, 4% were associated with epileptic seizure, and Ͻ1% were associated with infarction. In studies of the clinical course of 422 people with a DVA, the hemorrhage rate after first presentation ranged from 0% to 1.28% per year. In the population-based study of 93 adults with DVAs, 98% were incidental, 1% presented with symptomatic hemorrhage, and 1% presented with an infarct, but there were no symptomatic hemorrhages or infarcts in 492 person-years of follow-up (0% per person-year; 95% CI, 0% to 0.7%).

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Section: Discussionmentioning

confidence: 99%

Section: Characteristics Of Studiesmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

mentioning

confidence: 99%

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The Presentation and Clinical Course of Intracranial Developmental Venous Anomalies in Adults

Hon

Bhattacharya

Counsell

et al. 2009

Stroke

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“…42 Their clinical significance remains controversial, with some authors reporting a negligible hemorrhage risk 42 and others suggesting a higher risk. 76 In a series of 63 patients with known venous malformations followed longitudinally by Naff, et al, 91 the risk of hemorrhage was 0.15% per lesion-year. We believe a conservative approach to their management should be adopted, because the risks of radiosurgery or resection probably outweigh the risk of hemorrhage.…”

Section: Causes Of Sichmentioning

confidence: 98%

Spontaneous intracerebral hemorrhage: a review

Fewel¹,

Thompson²,

Hoff³

2003

FOC

143

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Spontaneous intracerebral hemorrhage (SICH) is a blood clot that arises in the brain parenchyma in the absence of trauma or surgery. This entity accounts for 10 to 15% of all strokes and is associated with a higher mortality rate than either ischemic stroke or subarachnoid hemorrhage. Common causes include hypertension, amyloid angiopathy, coagulopathy, vascular anomalies, tumors, and various drugs. Hypertension, however, remains the single greatest modifiable risk factor for SICH. Computerized tomography scanning is the initial diagnostic modality of choice in SICH, and angiography should be considered in all cases except those involving older patients with preexisting hypertension in thalamic, putaminal, or cerebellar hemorrhage. Medical management includes venous thrombosis prophylaxis, gastric cytoprotection, and aggressive rehabilitation. Anticonvulsant agents should be prescribed in supratentorial SICH, whereas the management of hypertension is controversial. To date, nine prospective randomized controlled studies have been conducted to compare surgical and medical management of SICH. Although definitive evidence favoring surgical intervention is lacking, there is good theoretical rationale for early surgical intervention. Surgery should be considered in patients with moderate to large lobar or basal ganglia hemorrhages and those suffering progressive neurological deterioration. Elderly patients in whom the Glasgow Coma Scale score is less than 5, those with brainstem hemorrhages, and those with small hemorrhages do not typically benefit from surgery. Patients with cerebellar hemorrhages larger than 3 cm, those with brainstem compression and hydrocephalus, or those exhibiting neurological deterioration should undergo surgical evacuation of the clot. It is hoped that the forthcoming results of the International Surgical Trial in IntraCerebral Hemorrhage will help formulate evidence-based recommendations regarding the role of surgery in SICH.

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Epilepsy and cerebral developmental venous anomalies (DVAs): A systematic review

Meskine

Reise

et al. 2023

Epileptic Disorders

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Objective Cerebral developmental venous anomalies (DVAs) are frequent and rarely symptomatic. When symptomatic, DVAs may present with seizures; however, little is known about the characteristics of DVA‐related epilepsy. In this systematic review, we aim to describe the clinical and paraclinical features of patients with DVA‐related epilepsy. Methods This review was registered on PROSPERO (CRD42021218711). We searched the MEDLINE/PubMed and Scopus databases for case reports/series on patients with DVAs complicated by seizures. Studies describing patients with a potentially epileptogenic comorbid lesion close to their seizure focus were excluded. Descriptive statistical analyses were performed to synthetize patient characteristics. The methodological quality of each study was evaluated using a standardized appraisal tool. Results In total, 66 patients were included from 39 articles. The frontal lobe was the most common location for DVAs. The superior sagittal sinus drained half of the DVAs. Seizures were inaugural in most cases, and the most common manifestations accompanying seizures were headaches. EEG was abnormal in 93% of cases, but only 26% had characteristic epileptic spikes. More than half the patients suffered a medical complication due to their DVA, with hemorrhage and thrombosis being the most common. Refractory seizures were encountered in 19% of individuals. At 12 months of follow‐up, 75% of patients were seizure free. Most included studies were at low risk of bias. Significance Epilepsy can be a complication of DVAs; these DVAs are mostly frontal or parietal, draining via the superior sagittal sinus or the vein of Galen.

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Venous angiomas: An underestimated cause of intracranial hemorrhage

Cited by 101 publications

References 23 publications

The Presentation and Clinical Course of Intracranial Developmental Venous Anomalies in Adults

The Presentation and Clinical Course of Intracranial Developmental Venous Anomalies in Adults

Spontaneous intracerebral hemorrhage: a review

Epilepsy and cerebral developmental venous anomalies (DVAs): A systematic review

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