Frequency of intracranial hemorrhage as a presenting symptom and subtype analysis: A population-based study of intracranial vascular malformations in Olmsted County, Minnesota
Frequency of intracranial hemorrhage as a presenting symptom and subtype analysis: A population-based study of intracranial vascular malformations in Olmsted County, Minnesota
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DOI：
10.3171/jns.1996.85.1.0029
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发表时间：
1996-07-01
影响因子：
4.1
通讯作者：
OFallon, WM
中科院分区：
文献类型：
--
作者：
Brown, RD;Wiebers, DO;OFallon, WM
这项研究的目的是确定在特定人群中由颅内血管畸形(IVMS)引起的症状和颅内出血(ICRH)的发生率。作者使用梅奥诊所医疗记录链接系统检测了1965至1992年间明尼苏达州奥姆斯特县居民中的所有IVM病例。在27年的时间里，共检测到48例IVMS。48例患者中有29例在出现症状时出现症状。最常见的症状是ICRH，20例患者中有20例，占所有有症状病例的69%。65%的动静脉畸形(AVM)表现为ICRH。脑出血最常见的亚型是脑出血，在20例患者中有9例；第二常见的亚型是蛛网膜下腔出血。出血高峰发生在生命的第五个十年。在明尼苏达州奥姆斯特德县的居民中，年龄和性别调整后的首次脑出血发病率为每10万人年0.82例(95%可信区间0.46-1.19)。在整个研究期间，与IVM相关的ICrH的检测没有增加。脑出血后30天的死亡率在动静脉畸形患者中为17.6%，在所有静脉内代谢综合征患者中为25%。这项研究提供了独一无二的关于IVMS患者临床症状、ICRH和出血亚型发生率的数据。
The purpose of this study was to determine the symptoms at presentation and the incidence of intracranial hemorrhage (ICrH) caused by intracranial vascular malformations (IVMs) in a defined population. The authors used the Mayo Clinic medical records linkage system to detect all cases of IVM among residents of Olmsted County, Minnesota, during the period 1965 through 1992. Forty-eight IVMs were detected over the 27-year period. Twenty-nine of the 48 patients were symptomatic at presentation. The most common presenting symptom was ICrH, which was present in 20 patients, 69% of all symptomatic cases. Sixty-five percent of arteriovenous malformations (AVMs) presented with ICrH. The most common subtype of ICrH was intracerebral hemorrhage, which was found in nine of 20 patients; the second most common subtype was subarachnoid hemorrhage. The peak occurrence of hemorrhage was during the fifth decade of life. The age- and gender-adjusted occurrence of a first ICrH from an IVM among residents of Olmsted County, Minnesota was 0.82 per 100,000 person years (95% confidence interval 0.46-1.19). There was no increase in the detection of IVM-related ICrH throughout the study period. The 30-day mortality rate following ICrH was 17.6% for patients with an AVM and 25% for all patients with IVMs. This study provides unique data on symptoms at presentation and the incidence of ICrH and hemorrhage subtypes from IVMs on a population basis.