Abstract Details

Title Long Term Follow Up of Incidentally Discovered Intracerebral Cavernous Malformations

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S49 - (-)

Poster/Presentation
Number 002

Objective

Background Up to 50% of intracerebral cavernous malformations (ICM) are asymptomatic and discovered incidentally. While some data exists regarding the natural history of these lesions, this data is normally found in the context of studies that do not differentiate between an initial symptomatic presentation and ICMs that are incidentally discovered. In addition, the follow up duration of these studies has been limited, typically 2-10 years.

Design/Methods 110 patients with incidentally discovered ICM diagnosed between 1989 and 1999 were identified from a previously published cohort. Updated clinical and radiographic data pertaining to symptomatic intracerebral hemorrhage related to the ICM were obtained by review of the medical chart and a mail survey. In select patients, phone calls were made and death certificates obtained. The prospective hemorrhage rate was calculated by number of prospective hemorrhages divided by the number of patient-years of followup.

Results Of the 110 patients (46.4% male; mean age of diagnosis 52.5 years), 1,324 patient-years of follow up was obtained. Twenty-four patients had died since previous followup and cause of death was able to be determined in 17. Three patients had a prospective hemorrhage. Thus, the prospective bleed rate was 0.23 per 100 person-years of follow-up. Five patients had developed seizures since previous follow-up.

Conclusions The risk of prospective hemorrhage in patients presenting asymptomatically with ICM is very low. This information can be useful in management decisions.

Authors/Disclosures
Samuel A. Moore, MD PRESENTER	No disclosure on file
Frederik Barkhof, MD, PhD (Image Analysis Center)	Frederik Barkhof has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Frederik Barkhof has received personal compensation in the range of $0-$499 for serving as a Consultant for Biogen. Frederik Barkhof has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Combinostics. Frederik Barkhof has received personal compensation in the range of $500-$4,999 for serving as a Consultant for IXICO. Frederik Barkhof has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Frederik Barkhof has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EISAI.
	No disclosure on file
Kelly D. Flemming, MD (Mayo Clinic)	Dr. Flemming has nothing to disclose.

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