Brown R D, Wiebers D O, Forbes G, O'Fallon W M, Piepgras D G, Marsh W R, Maciunas R J
Department of Neurology, Mayo Clinic, Rochester, Minnesota.
J Neurosurg. 1988 Mar;68(3):352-7. doi: 10.3171/jns.1988.68.3.0352.
The authors conducted a long-term follow-up study of 168 patients to define the natural history of clinically unruptured intracranial arteriovenous malformations (AVM's). Charts of patients seen at the Mayo Clinic between 1974 and 1985 were reviewed. Follow-up information was obtained on 166 patients until death, surgery, or other intervention, or for at least 4 years after diagnosis (mean follow-up time 8.2 years). All available cerebral arteriograms and computerized tomography scans of the head were reviewed. Intracranial hemorrhage occurred in 31 patients (18%), due to AVM rupture in 29 and secondary to AVM or aneurysm rupture in two. The mean risk of hemorrhage was 2.2% per year, and the observed annual rates of hemorrhage increased over time. The risk of death from rupture was 29%, and 23% of survivors had significant long-term morbidity. The size of the AVM and the presence of treated or untreated hypertension were of no value in predicting rupture.
作者对168例患者进行了长期随访研究，以明确临床未破裂颅内动静脉畸形（AVM）的自然病程。回顾了1974年至1985年间在梅奥诊所就诊患者的病历。获得了166例患者直至死亡、手术或其他干预，或诊断后至少4年（平均随访时间8.2年）的随访信息。回顾了所有可用的脑部动脉造影和头部计算机断层扫描。31例患者（18%）发生颅内出血，其中29例因AVM破裂，2例继发于AVM或动脉瘤破裂。出血的平均风险为每年2.2%，观察到的年出血率随时间增加。破裂导致的死亡风险为29%，23%的幸存者有明显的长期致残率。AVM的大小以及是否存在已治疗或未治疗的高血压对预测破裂无价值。
