Long-term antithrombotic therapy and risk of intracranial haemorrhage from cerebral cavernous malformations: a population-based cohort study, systematic review, and meta-analysis

Publication date: Available online 7 August 2019Source: The Lancet NeurologyAuthor(s): Susanna M Zuurbier, Charlotte R Hickman, Christos S Tolias, Leon A Rinkel, Rebecca Leyrer, Kelly D Flemming, David Bervini, Giuseppe Lanzino, Robert J Wityk, Hans-Martin Schneble, Ulrich Sure, Rustam Al-Shahi Salman, Scottish Audit of Intracranial Vascular Malformations Steering CommitteeSummaryBackgroundAntithrombotic (anticoagulant or antiplatelet) therapy is withheld from some patients with cerebral cavernous malformations, because of uncertainty around the safety of these drugs in such patients. We aimed to establish whether antithrombotic therapy is associated with an increased risk of intracranial haemorrhage in adults with cerebral cavernous malformations.MethodsIn this population-based, cohort study, we used data from the Scottish Audit of Intracranial Vascular Malformations, which prospectively identified individuals aged 16 years and older living in Scotland who were first diagnosed with a cerebral cavernous malformation during 1999–2003 or 2006–10. We compared the association between use of antithrombotic therapy after first presentation and the occurrence of intracranial haemorrhage or persistent or progressive focal neurological deficit due to the cerebral cavernous malformations during up to 15 years of prospective follow-up with multivariable Cox proportional hazards regression assessed in all individuals identified in the database. We also did a systematic review and met...
Source: The Lancet Neurology - Category: Neurology Source Type: research