Featured Research

from universities, journals, and other organizations

Conservative management of vascular abnormality in brain associated with better outcomes

Date:
April 22, 2014
Source:
The JAMA Network Journals
Summary:
Patients with arteriovenous malformations (abnormal connection between arteries and veins) in the brain that have not ruptured had a lower risk of stroke or death for up to 12 years if they received conservative management of the condition compared to an interventional treatment, according to a study.

Patients with arteriovenous malformations (abnormal connection between arteries and veins) in the brain that have not ruptured had a lower risk of stroke or death for up to 12 years if they received conservative management of the condition compared to an interventional treatment, according to a study in the April 23/30 issue of JAMA, a neurology theme issue.

Related Articles


Interventional treatment for brain arteriovenous malformations (bAVMs) with procedures such as neurosurgical excision, endovascular embolization, or stereotactic radiosurgery can be used alone or in combination to attempt to obliterate bAVMs. Because interventions may have complications and the untreated clinical course of unruptured bAVMs can be benign, some patients choose conservative management (no intervention). Guidelines have endorsed both intervention and conservative management for unruptured bAVMs. Whether conservative management is superior to interventional treatment for unruptured bAVMs is uncertain because of the lack of long-term experience, according to background information in the article.

Rustam Al-Shahi Salman, Ph.D., of the University of Edinburgh, Scotland, and colleagues with the Scottish Audit of Intracranial Vascular Malformations Collaborators, studied 204 residents of Scotland (16 years of age or older) who were first diagnosed as having an unruptured bAVM during 1999-2003 or 2006-2010 and followed over time. The researchers analyzed the outcomes for patients who received conservative management (no intervention; medications for seizures) or an intervention (any endovascular embolization, neurosurgical excision, or stereotactic radiosurgery alone or in combination).

Of the 204 patients, 103 underwent some type of intervention. Those who underwent intervention were younger, more likely to have presented with seizure, and less likely to have large bAVMs than patients managed conservatively. During a median (midpoint) follow-up of 6.9 years, the rate of progression to sustained disability or death was lower with conservative management during the first 4 years of follow-up, but rates were similar thereafter. The rate of nonfatal stroke or death (due to the bAVM or intervention) was lower with conservative management during 12 years of follow-up (14 vs 38 events).

"The similarity of the results of this observational study and ARUBA [a randomized clinical trial that examined this issue] and the persistent difference between the outcome of conservative management and intervention during 12-year follow-up in our study support the superiority of conservative management to intervention for unruptured bAVMs, which may deter some patients and physicians from intervention," the authors write.

"Long-term follow-up in both this study and the ARUBA trial is needed to establish whether the superiority of conservative management will persist or change."


Story Source:

The above story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Rustam Al-Shahi Salman, Philip M. White, Carl E. Counsell, Johann du Plessis, Janneke van Beijnum, Colin B. Josephson, Tim Wilkinson, Catherine J. Wedderburn, Zoe Chandy, E. Jerome St. George, Robin J. Sellar, Charles P. Warlow. Outcome After Conservative Management or Intervention for Unruptured Brain Arteriovenous Malformations. JAMA, 2014; 311 (16): 1661 DOI: 10.1001/jama.2014.3200

Cite This Page:

The JAMA Network Journals. "Conservative management of vascular abnormality in brain associated with better outcomes." ScienceDaily. ScienceDaily, 22 April 2014. <www.sciencedaily.com/releases/2014/04/140422162301.htm>.
The JAMA Network Journals. (2014, April 22). Conservative management of vascular abnormality in brain associated with better outcomes. ScienceDaily. Retrieved October 31, 2014 from www.sciencedaily.com/releases/2014/04/140422162301.htm
The JAMA Network Journals. "Conservative management of vascular abnormality in brain associated with better outcomes." ScienceDaily. www.sciencedaily.com/releases/2014/04/140422162301.htm (accessed October 31, 2014).

Share This



More Health & Medicine News

Friday, October 31, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Melafind: Spotting Melanoma Without a Biopsy

Melafind: Spotting Melanoma Without a Biopsy

Ivanhoe (Oct. 31, 2014) The MelaFind device is a pain-free way to check suspicious moles for melanoma, without the need for a biopsy. Video provided by Ivanhoe
Powered by NewsLook.com
Battling Multiple Myeloma

Battling Multiple Myeloma

Ivanhoe (Oct. 31, 2014) The answer isn’t always found in new drugs – repurposing an ‘old’ drug that could mean better multiple myeloma treatment, and hope. Video provided by Ivanhoe
Powered by NewsLook.com
Chronic Inflammation and Prostate Cancer

Chronic Inflammation and Prostate Cancer

Ivanhoe (Oct. 31, 2014) New information that is linking chronic inflammation in the prostate and prostate cancer, which may help doctors and patients prevent cancer in the future. Video provided by Ivanhoe
Powered by NewsLook.com
Sickle Cell: Stopping Kids’ Silent Strokes

Sickle Cell: Stopping Kids’ Silent Strokes

Ivanhoe (Oct. 31, 2014) Blood transfusions are proving crucial to young sickle cell patients by helping prevent strokes, even when there is no outward sign of brain injury. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins