ORCID Profile
0000-0003-0041-2833
Current Organisations
Karolinska University Hospital
,
Leiden University Medical Center
,
Institute of Human Genetics of the Polish Academy of Sciences
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Publisher: SAGE Publications
Date: 27-02-2017
Abstract: It is unclear whether the risk of bleeding from brain arteriovenous malformations is higher during pregnancy, delivery, or puerperium. We compared occurrence of brain arteriovenous malformation hemorrhage in women during this period with occurrence of hemorrhage outside this period during their fertile years. We included all women with ruptured brain arteriovenous malformations (16–41 years) from a retrospective database of patients with brain arteriovenous malformations in four Dutch university hospitals (n = 95) and from the population-based Scottish Audit of Intracranial Vascular Malformations (n = 44). We estimated the relative rate of brain arteriovenous malformation rupture (before any treatment) during exposed time (pregnancy, delivery, puerperium) versus non-exposed time during fertile years, using the case-crossover design as primary analysis, and the self-controlled case-series design as secondary analysis. In 17 of 95 Dutch women and in 3 of 44 Scottish women, hemorrhages occurred while pregnant none occurred during delivery or puerperium. In Dutch women, the relative rate of brain arteriovenous malformation rupture during pregnancy, delivery, or puerperium was 6.8 (95% confidence interval 3.6–13) according to the case-crossover method and 7.1 (95% confidence interval 3.4–13) using the self-controlled case-series method. In Scottish women, the relative rate was 1.3 (95% confidence interval 0.39–4.1) using the case-crossover method and 1.7 (95% confidence interval 0.0–4.4) according to the self-controlled case-series method. Because of limited overlap of confidence intervals, we refrained from pooling the cohorts. Case-crossover and self-controlled case series analyses reveal an increase in relative rate of brain arteriovenous malformation rupture during pregnancy in the Dutch cohort but not in the Scottish cohort. Since point estimates varied between both cohorts and numbers are relatively small, the clinical implications of our findings are uncertain.
Publisher: SAGE Publications
Date: 09-07-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2014
DOI: 10.1161/STROKEAHA.114.005442
Abstract: It is uncertain whether familial occurrence of brain arteriovenous malformations (BAVMs) represents coincidental aggregation or a shared familial risk factor. We aimed to compare the prevalence of BAVMs in first-degree relatives (FDRs) of patients with BAVM and the prevalence in the general population. We sent a postal questionnaire to 682 patients diagnosed with a BAVM in 1 of 4 university hospitals to retrieve information about the occurrence of BAVMs among their FDRs. We calculated a prevalence ratio using the BAVM prevalence among FDRs and the prevalence from a Scottish population-based study (93 per 628 788 adults). A prevalence ratio of ≥9 with a lower limit of the 95% confidence interval of 3 was considered indicative of a shared familial risk factor. Informed consent was given by 460 (67%) patients, who had 2992 FDRs. We identified 3 patients with a FDR with a BAVM, yielding a prevalence ratio of 6.8 (95% CI, 2.2–21). The prevalence of BAVMs in FDRs of patients with a BAVM was increased but did not meet our prespecified criterion for a shared familial risk factor. In combination with the low absolute risk of a BAVM in FDRs, our results do not support screening of FDRs for BAVMs.
Publisher: Public Library of Science (PLoS)
Date: 07-01-2020
Location: Poland
No related grants have been discovered for Patrick A. Brouwer.