{
  "abstract": "Introduction/Purpose Cerebral arteriovenous malformations (AVM) are abnormal connections between arteries and veins that present with hemorrhage, seizure, headaches, or focal neurological deficits. Estimates of AVM prevalence and natural history (i.e. rupture rate) have historically been based on detection of symptomatic lesions. Nevertheless, with increased use of advanced neuroimaging, we wanted to see if observational studies reported increased incidental detection of AVMs over time.Materials and Methods We conducted a systematic review of PubMed following PRISMA guidelines. We included all population-based observational (cohort) studies including novel estimates of cerebral AVM population prevalence. Our hypothesis was that this would increase along with increased incidental detection through advanced neuroimaging.Results Our systematic review identified 534 articles, of which 8 met inclusion criteria. Included articles were published between 1996 and 2020. There were 3 American studies and 1 each from Australia, Sweden, Scotland, Denmark, and Korea. All studies reported detection rates as incidences, which ranged from 0.4 per 100000 person-years in a Danish pediatric population (estimated population prevalence 1 in 3000) to 4.4 per 100,000 person-years in a Korean adult population (estimated 1 in 272 prevalence). The remaining 6 studies all reported estimated prevalence between 1 in 1250 and 833. While there was an increasing trend in estimated prevalence over time, this was entirely due to the 2020 Korean study, limiting external validity for this finding. No study detected an increase in incidental AVMs over time associated with increased use of advanced neuroimaging.Conclusion The true prevalence of cerebral AVMs in the population is unknown. While there are numerous case reports and series describing incidentally-found AVMs, our systematic review including population-based observational studies did not find evidence of increased incidental detection of cerebral AVMs over time. Nevertheless, study populations were heterogeneous, and many included studies predate the recent increased use of advanced neuroimaging. Additional questions remain for well-designed cohort studies, including whether incidentally-discovered AVMs have a different natural history and rupture risk compared to symptomatic AVMs.Disclosures C. Carr: None. S. Rahimi: None.",
  "authors": [
    {
      "affiliations": [
        "MCG, North Augusta, SC"
      ],
      "name": "C Carr"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Medical College of Georgia at Augusta University, Augusta, GA"
      ],
      "name": "J Cliett"
    },
    {
      "affiliations": [
        "Neurosurgery, Augusta University, Augusta, GA"
      ],
      "name": "G Tandra"
    },
    {
      "affiliations": [
        "Neurosurgery, Augusta University, Augusta, GA"
      ],
      "name": "L Debs"
    },
    {
      "affiliations": [
        "MCG, Augusta, GA"
      ],
      "name": "S Rahimi"
    }
  ],
  "title": "E-218 Incidental detection of cerebral arteriovenous malformations over time: systematic review of observational studies with implications for population prevalence estimates and natural history",
  "uid": "6428310c-ba5d-5ba3-ae6c-8c5151ff6e47"
}