Editorial comment--Age-dependent brain AVM characteristics: what is the evidence?

Abstract

Cerebral arteriovenous malformations (AVMs) came to clinical attention more than a century ago,1 and since that time, they have been recognized as lesions that can cause serious neurological deficits or death. Although AVMs can present mostly with hemorrhage or seizure, the advent of contemporary brain imaging techniques has allowed an increasing number of AVMs to be detected before rupture. Over the last decade, there has been a growing interest in knowing more about the incidence, frequency, and clinical course of these vascular lesions; thus, both retrospective and prospective-based studies offering new insights have accumulated. Population-based studies have reported that half of the adults with a first presentation of brain AVM have intracranial hemorrhage.2 Other important presenting symptoms include seizures, headaches, progressive neurological deficit, pulsatile tinnitus, and other unrelated symptoms that lead to a fortuitous diagnosis.3 Finally, an AVM can be suggested by a distinctive combination of these features. An understanding of the different modes of presentation and their relative frequencies …