Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3801_Библиотеки_им_академика_М_И_Перельмана

There is very little information in the literature about the prevalence of AVMs, i.e., the propor­tion of a population living with the diagnosis of AVM at a single point in time. Because of the rarity of the disease and the existence of asymptomatic patients, establishing a true prevalence rate is dif­fi cult and probably not feasible (Stapf et al. 2000). Considering unselected populations, Al-Shahi and Wa rl ow (2001) found a prevalence of AVMs in a retrospective study in a region of Scotland of 15 per 100,000 living adults over 16 years of age. In this series, prevalence is obviously underesti­mated, since it does not consider asymptomatic AVMs. Only large post-mortem studies in the gen­eral population could give a more accurate estima­tion of the prevalence of both symptomatic and clinically silent AVM. However, such a series does not exist. Only few hospital-based post-mortem studies are available, in which the prevalence of AVMs was found to be between 400 and 600 per 100,000 (Al-Shahi and Wa rl ow 2001; Berman et al. 2000; Jellinger 1986). This huge discrepancy is obviously due to the fact that the prevalence in living subjects is underestimated, fi rst because of the lack of diagnosed cases being fi led in a regis­try in retrospective studies, and second because the entire group of nonsymptomatic AVMs are not included in the counting because they are not detected. Berman et al. (2000) have provided a very interesting paper in which they reviewed all of the relevant original literature. They conclude that “the estimates for AVM prevalence that are published in the medical literature are unfounded”. For these authors, the most reliable estimate for the occurrence of the disease is the detection rate for symptomatic lesions: 0.94 per 100,000 persons per year.