Prognosis and management of intracranial vascular malformations

Prognosis and management of intracranial vascular malformations and non-traumatic intracerebral haemorrhage in adults

Intracranial vascular malformations (IVMs) are responsible for over one-third of spontaneous (non-traumatic) intracerebral haemorrhage (ICH) in young adults, making them the leading cause in this age group. Therefore, IVMs are likely to be directly costly to the NHS (prolonged and repeated inpatient stays in acute and rehabilitation sectors) and indirectly costly to society (loss of productivity). This study assessed the scale of both sets of costs, using responses from a national population-based cohort. Questionnaire response and completion rates were good, with little evidence of response bias. The burden associated with lost productivity was greater than healthcare costs, reflecting the disabling and sometimes fatal nature of IVMs among adults of working age.

Outcome and Translation

This was the first cost-of-illness study for IVMs on an unselected, population-based cohort. The scale of the cost burden is large and suggests that development of effective interventions that reduce the prevalence of IVMs should be a priority for the clinical community dealing with ICH. The priority now is to develop such interventions and evaluate their clinical and cost-effectiveness.

HERU researchers involved in this research project: Paul McNamee and Zahidul Quayyum

External collaborators: A-S Rustam (University of Edinburgh)

Publications

Miller, C.E., Quayyum, Z., McNamee, P. and Salman, R. A-S. Economic burden of intracranial vascular malformations in adults: prospective, population-based study. Stroke 2009; 40: 1973-1979.

Presentations

Miller C.E., McNamee, P. and Salman, R.A.S. Economic burden of intracranial vascular malformations in adults: prospective, population-based study. European Stroke Conference. Glasgow, 2007.