Stroke risk rises if common brain blood vessel condition is treated

23 April 2014

Anne Rowling Clinic researchers have published findings that treating patients with a common brain blood vessel condition increases their risk of stroke.

People with a condition known as Arteriovenous Malformation (AVM) – which affects blood vessels in the brain – have a better outcome if doctors treat their symptoms only and not the AVM.

Professor Rustam Al-Shahi Salman, who leads the Stroke due to Brain Haemmorhage Clinic and Research team, compared the long-term outcome of patients with the condition, which is caused by tangles that are formed by abnormal connections between the arteries and veins in the brain. The tangles affect 1 in 2,000 people and can bleed at any time, causing a stroke.

They found that, for the 12 years of data studied, patients who chose not to be treated for their condition were less likely to have a stroke or die from related causes. These patients were also less likely to suffer sustained disability compared with those who opted for an intervention to treat the tangles.

In some cases doctors can surgically remove the tangles or block the blood vessels involved to reduce the risk of bleeding. However, treatment also carries risks of complications, which are the same as the problems treatment tries to prevent.

Although many people with AVM can lead relatively normal lives, they live with around a one in one hundred risk that the tangle will burst and cause a stroke each year.

Many patients feel that living with AVM is like living with a time bomb in your head that could explode at any time. Patients and their doctors face difficult choices when deciding whether or not to pursue treatment. We have found that, for most people whose AVM has not caused a bleed, the risks of treatment exceed the benefits over 12 years.

Professor Al-Shahi Salman


The findings are published today in the Journal of the American Medical Association: jama.jamanetwork.com/article.aspx?articleid=1861801

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