OBJECTIVE: To determine if the rate of hemorrhage was increased in patients with CCMs taking AT.BACKGROUND: CCMs are vascular malformations of the brain and spine that can present with seizure or hemorrhage, but are frequently found as incidental findings on MRI. CCMs in general are thought to have a low risk of recurrent hemorrhage, on the order of 0.2 to 4.0 % per person per year.DESIGN/METHODS: From a clinical database, 52 patients with either cerebral or spinal CCMs were retrospectively reviewed.RESULTS:Among 52 patients, CCMs were located in the brain in 50 (including brainstem in 17) and in the thoracic spine in 2; 16 were multiple on MRI. Mean age was 54 years; 60% female; 77% white. Medical history: migraine (44%), HTN (39%) and previous seizures (21%). The most common presenting symptoms at the time of diagnosis were incidental finding in 30 and hemorrhage in 17. Follow-up was a mean of 4.3 years.During follow-up, 7 patients had recurrent hemorrhage. The overall rate of hemorrhage was 3.1% per person year, and was independent of age, race, sex, risk factors, brainstem location and hemorrhage at the time of initial diagnosis.AT were used at some point during follow-up in 12 patients (antiplatelet 6, anticoagulation 1, combination 5). The mean length of time patients were on AT was 1.6 years (range 1 month to 9.3 years). None of the 7 patients with recurrent hemorrhage were on AT at the time of the bleed.CONCLUSIONS: There is no apparent increase in the rate of hemorrhage in CCM patients while taking AT, although the small number of patients may limit the power to detect a difference. We are expanding this study to include a larger clinical database.Study Supported by:
Disclosure: Dr. Wityk has nothing to disclose.
Original Article: http://www.neurology.org/cgi/content/short/82/10_Supplement/P2.102?rss=1
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