The natural history of symptomatic arteriovenous malformations of the brain: a 24-year follow-up assessment

Stephen L. Ondra Division of Neurosurgery, Walter Reed Army Medical Center, Washington, D.C., and Department of Neurosurgery, Helsinki University, Helsinki, Finland

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 M.D.
,
Henry Troupp Division of Neurosurgery, Walter Reed Army Medical Center, Washington, D.C., and Department of Neurosurgery, Helsinki University, Helsinki, Finland

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 M.D.
,
Eugene D. George Division of Neurosurgery, Walter Reed Army Medical Center, Washington, D.C., and Department of Neurosurgery, Helsinki University, Helsinki, Finland

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 M.D.
, and
Karen Schwab Division of Neurosurgery, Walter Reed Army Medical Center, Washington, D.C., and Department of Neurosurgery, Helsinki University, Helsinki, Finland

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 Ph.D.
Page Range:
387–391
Volume/Issue:
Volume 73: Issue 3
DOI link:
https://doi.org/10.3171/jns.1990.73.3.0387
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✓ The authors have updated a series of 166 prospectively followed unoperated symptomatic patients with arteriovenous malformations (AVM's) of the brain. Follow-up data were obtained for 160 (96%) of the original population, with a mean follow-up period of 23.7 years. The rate of major rebleeding was 4.0% per year, and the mortality rate was 1.0% per year. At follow-up review, 23% of the series were dead from AVM hemorrhage. The combined rate of major morbidity and mortality was 2.7% per year. These annual rates remained essentially constant over the entire period of the study. There was no difference in the incidence of rebleeding or death regardless of presentation with or without evidence of hemorrhage. The mean interval between initial presentation and subsequent hemorrhage was 7.7 years.

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Contributor Notes

Address reprint requests to: Stephen L. Ondra, M.D., Division of Neurosurgery, Walter Reed Army Medical Center, Washington, D.C. 20307-5001.
  • 1.

    Brown RD Jr, , Wiebers DO, & Forbes G, et al: The natural history of unruptured intracranial arteriovenous malformations. J Neurosurg 68:352–357, 1988 Brown RD Jr, Wiebers DO, Forbes G, et al: The natural history of unruptured intracranial arteriovenous malformations. J Neurosurg 68:352–357, 1988

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Central Statistical Office of Finland: Causes of Death in Finland. Helsinki, Finland: Government Printing Office, 1987 Central Statistical Office of Finland: Causes of Death in Finland. Helsinki, Finland: Government Printing Office, 1987

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Crawford PM, , West CR, & Chadwick DW, et al: Arteriovenous malformations of the brain: natural history in unoperated patients. J Neurol Neurosurg Psychiatry 49:1–10, 1986 Crawford PM, West CR, Chadwick DW, et al: Arteriovenous malformations of the brain: natural history in unoperated patients. J Neurol Neurosurg Psychiatry 49:1–10, 1986

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Forster DMC, , Steiner L, & Håkanson S: Arteriovenous malformations of the brain. A long-term clinical study. J Neurosurg 37:562–570, 1972 Forster DMC, Steiner L, Håkanson S: Arteriovenous malformations of the brain. A long-term clinical study. J Neurosurg 37:562–570, 1972

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Fults D, & Kelly DL Jr: Natural history of arteriovenous malformations of the brain: a clinical study. Neurosurgery 15:658–662, 1984 Fults D, Kelly DL Jr: Natural history of arteriovenous malformations of the brain: a clinical study. Neurosurgery 15:658–662, 1984

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Graf CJ, , Perret GE, & Torner JC: Bleeding from cerebral arteriovenous malformations as part of their natural history. J Neurosurg 58:331–337, 1983 Graf CJ, Perret GE, Torner JC: Bleeding from cerebral arteriovenous malformations as part of their natural history. J Neurosurg 58:331–337, 1983

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Guidetti B, & Delitala A: Intracranial arteriovenous malformations. Conservative and surgical treatment. J Neurosurg 53:149–152, 1980 Guidetti B, Delitala A: Intracranial arteriovenous malformations. Conservative and surgical treatment. J Neurosurg 53:149–152, 1980

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Jane JA, , Kassell NF, & Torner JC, et al: The natural history of aneurysms and arteriovenous malformations. J Neurosurg 62:321–323, 1985 Jane JA, Kassell NF, Torner JC, et al: The natural history of aneurysms and arteriovenous malformations. J Neurosurg 62:321–323, 1985

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Luessenhop AJ: Natural history of cerebral arteriovenous malformations, in Wilson CB, & Stein BM (eds): Intracranial Arteriovenous Malformations. Baltimore: Williams & Wilkins, 1984, pp 12–23 Luessenhop AJ: Natural history of cerebral arteriovenous malformations, in Wilson CB, Stein BM (eds): Intracranial Arteriovenous Malformations. Baltimore: Williams & Wilkins, 1984, pp 12–23

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    MacMahon B, & Pugh TF: Epidemiology Principles and Methods. Boston: Little, Brown, & Co, 1970, pp 228–230 MacMahon B, Pugh TF: Epidemiology Principles and Methods. Boston: Little, Brown, & Co, 1970, pp 228–230

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Olivecrona H, & Riives J: Arteriovenous aneurysms of the brain: their diagnosis and treatment. Arch Neurol Psychiatry 59:567–602, 1948 Olivecrona H, Riives J: Arteriovenous aneurysms of the brain: their diagnosis and treatment. Arch Neurol Psychiatry 59:567–602, 1948

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Perret G, & Nishioka H: Report of the Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemorrhage. Section VI. Arteriovenous malformations. An analysis of 545 cases of cranio-cerebral arteriovenous malformations and fistulae reported to the Cooperative Study. J Neurosurg 25:467–490, 1966 Perret G, Nishioka H: Report of the Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemorrhage. Section VI. Arteriovenous malformations. An analysis of 545 cases of cranio-cerebral arteriovenous malformations and fistulae reported to the Cooperative Study. J Neurosurg 25:467–490, 1966

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Svien HJ, & McRae JA: Arteriovenous anomalies of the brain. Fate of patients not having definitive surgery. J Neurosurg 23:23–28, 1965 Svien HJ, McRae JA: Arteriovenous anomalies of the brain. Fate of patients not having definitive surgery. J Neurosurg 23:23–28, 1965

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Svien HJ, , Olive I, & Angulo-Rivero P: The fate of patients who have cerebral arteriovenous anomalies without definitive surgical treatments. J Neurosurg 13:381–387, 1956 Svien HJ, Olive I, Angulo-Rivero P: The fate of patients who have cerebral arteriovenous anomalies without definitive surgical treatments. J Neurosurg 13:381–387, 1956

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Troupp H: Arteriovenous malformations of the brain. Acta Neurochir 41:39–42, 1965 Troupp H: Arteriovenous malformations of the brain. Acta Neurochir 41:39–42, 1965

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Troupp H, , Marttila I, & Halonen V: Arteriovenous malformations of the brain. Prognosis without operation. Acta Neurochir 22:125–128, 1970 Troupp H, Marttila I, Halonen V: Arteriovenous malformations of the brain. Prognosis without operation. Acta Neurochir 22:125–128, 1970

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Wilkins RH: Natural history of intracranial vascular malformations: a review. Neurosurgery 16:421–430, 1985 Wilkins RH: Natural history of intracranial vascular malformations: a review. Neurosurgery 16:421–430, 1985

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

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