DOI: 10.3171/jns.1985.62.3.0321. The natural history of aneurysms and arteriovenous malformations

The natural history of aneurysms and arteriovenous malformations

10.3171/jns.1985.62.3.0321

Crossref journal-article

Journal of Neurosurgery Publishing Group (JNSPG)

Journal of Neurosurgery (1754)

Abstract

✓ The authors summarize the findings of previous studies relating to the natural history of aneurysms and arteriovenous malformations (AVM's). Ruptured aneurysms have their highest rate of rebleeding on Day 1, and at least 50% will rebleed during the 6 months after the first hemorrhage. Thereafter, the rate drops to at least 3% a year. This is the same rate as seen in anterior and posterior communicating artery aneurysms treated by anterior cerebral artery clipping and carotid ligation; these operations provide immediate protection but do not result in long-term diminution of the risk of rebleeding. Patients with unruptured incidental and unruptured multiple aneurysms rebleed at a rate of 1% per year, as do patients with subarachnoid hemorrhage of unknown etiology. The risk of rebleeding for AVM's is 3% a year.

Bibliography

Jane, J. A., Kassell, N. F., Torner, J. C., & Winn, H. R. (1985). The natural history of aneurysms and arteriovenous malformations. Journal of Neurosurgery, 62(3), 321â323.

Authors 4

John A. Jane (first)
Neal F. Kassell (additional)
James C. Torner (additional)
H. Richard Winn (additional)

References 18 Referenced 236

10.3171/jns.1983.58.3.0331 / J Neurosurg / Bleeding from cerebral arteriovenous malformations as part of their natural history. by Graf (1983)
10.1161/01.STR.8.5.579 / Stroke / Intracranial aneurysms and subarachnoid hemorrhage — report on a randomized treatment study. IV-B. Regulated bedrest — statistical evaluation. by Henderson (1977)
10.1093/neurosurgery/24.CN_suppl_1.176 / Clin Neurosurg / The natural history of intracranial aneurysms: rebleeding rates during the acute and long term period and implications for surgical management. by Jane (1977)
10.1016/S0733-8619(18)31172-1 / Neurol Clin North Am / Review of the management of saccular aneurysms. by Kassell (1983)
10.1227/00006123-198311000-00001 / Neurosurgery / Aneurysmal rebleeding: a preliminary report from the Cooperative Aneurysm Study. by Kassell (1983)
{'key': 'b6', 'series-title': 'Lancet', 'first-page': '1203', 'article-title': 'Posterior-communicating aneurysms. A controlled trial of the conservative and surgical treatment of ruptured aneurysms of the internal carotid artery at or near the point of origin of the posterior communicating artery.', 'volume': '1', 'author': 'McKissock', 'year': '1960'} / Lancet / Posterior-communicating aneurysms. A controlled trial of the conservative and surgical treatment of ruptured aneurysms of the internal carotid artery at or near the point of origin of the posterior communicating artery. by McKissock (1960)
10.1001/archneur.1984.04050220036011 / Arch Neurol / Cooperative study of intracranial aneurysms and subarachnoid hemorrhage: long-term prognostic study II. Ruptured intracranial aneurysms managed conservatively. by Nishioka (1984)
10.1001/archneur.1984.04050220041012 / Arch Neurol / Cooperative study of intracranial aneurysms and subarachnoid hemorrhage: long-term prognostic study III. Subarachnoid hemorrhage of undetermined etiology. by Nishioka (1984)
{'key': 'b9', 'series-title': 'J Neurosurg', 'first-page': '226', 'article-title': 'Assessment of the natural history of anterior communicating aneurysms.', 'volume': '21', 'author': 'Richardson', 'year': '1964'} / J Neurosurg / Assessment of the natural history of anterior communicating aneurysms. by Richardson (1964)
10.3171/jns.1966.25.3.0280 / J Neurosurg / The prediction of morbidity and mortality in anterior communicating aneurysms treated by proximal anterior cerebral ligation. by Richardson (1966)
10.1001/archneur.1966.00470080056008 / Arch Neurol / Prognostic factors in the untreated course of posterior communicating aneurysms. by Richardson (1966)
{'key': 'b12', 'series-title': 'Aneurysmal Subarachnoid Hemorrhage. Report of the Cooperative Study.', 'year': '1981'} / Aneurysmal Subarachnoid Hemorrhage. Report of the Cooperative Study. (1981)
{'key': 'b13', 'series-title': 'Aneurysmal Subarachnoid Hemorrhage. Report of the Cooperative Study.', 'first-page': '249', 'article-title': 'Statistical comparisons of end results of a randomized study', 'author': 'Torner', 'year': '1981'} / Aneurysmal Subarachnoid Hemorrhage. Report of the Cooperative Study. / Statistical comparisons of end results of a randomized study by Torner (1981)
10.3171/jns.1983.59.4.0642 / J Neurosurg / The long-term outcome in patients with multiple aneurysms. Incidence of late hemorrhage and implications for treatment of incidental aneurysms. by Winn (1983)
10.3171/jns.1977.47.5.0727 / J Neurosurg / Late morbidity and mortality of common carotid ligation for posterior communicating aneurysms. A comparison to conservative treatment. by Winn (1977)
10.1002/ana.410010407 / Ann Neurol / The long-term prognosis in untreated cerebral aneurysms: I. The incidence of late hemorrhage in cerebral aneurysm: a 10-year evaluation of 364 patients. by Winn (1977)
10.1002/ana.410040506 / Ann Neurol / The longterm prognosis in untreated cerebral aneurysms: II. Late morbidity and mortality. by Winn (1978)
{'key': 'b18', 'series-title': 'Stroke', 'first-page': '121', 'article-title': 'Prevalence of asymptomatic incidental aneurysms: review of 4,568 arteriograms.', 'volume': '14', 'author': 'Winn', 'year': '1983'} / Stroke / Prevalence of asymptomatic incidental aneurysms: review of 4,568 arteriograms. by Winn (1983)

Dates

Type	When
Created	16 years, 3 months ago (May 8, 2009, 12:19 p.m.)
Deposited	3 years, 1 month ago (July 24, 2022, 3:16 p.m.)
Indexed	2 months ago (June 28, 2025, 5:03 a.m.)
Issued	40 years, 5 months ago (March 1, 1985)
Published	40 years, 5 months ago (March 1, 1985)
Published Print	40 years, 5 months ago (March 1, 1985)

Funders 0

None

BibTeX

@article{Jane_1985, title={The natural history of aneurysms and arteriovenous malformations}, volume={62}, ISSN={0022-3085}, url={http://dx.doi.org/10.3171/jns.1985.62.3.0321}, DOI={10.3171/jns.1985.62.3.0321}, number={3}, journal={Journal of Neurosurgery}, publisher={Journal of Neurosurgery Publishing Group (JNSPG)}, author={Jane, John A. and Kassell, Neal F. and Torner, James C. and Winn, H. Richard}, year={1985}, month=mar, pages={321–323} }

JSON

{
  "indexed": {
    "date-parts": [
      [
        2025,
        6,
        28
      ]
    ],
    "date-time": "2025-06-28T09:03:46Z",
    "timestamp": 1751101426291
  },
  "reference-count": 18,
  "publisher": "Journal of Neurosurgery Publishing Group (JNSPG)",
  "issue": "3",
  "content-domain": {
    "domain": [],
    "crossmark-restriction": false
  },
  "published-print": {
    "date-parts": [
      [
        1985,
        3
      ]
    ]
  },
  "abstract": "<jats:p content-type=\"fine-print\">\u2713 The authors summarize the findings of previous studies relating to the natural history of aneurysms and arteriovenous malformations (AVM's). Ruptured aneurysms have their highest rate of rebleeding on Day 1, and at least 50% will rebleed during the 6 months after the first hemorrhage. Thereafter, the rate drops to at least 3% a year. This is the same rate as seen in anterior and posterior communicating artery aneurysms treated by anterior cerebral artery clipping and carotid ligation; these operations provide immediate protection but do not result in long-term diminution of the risk of rebleeding. Patients with unruptured incidental and unruptured multiple aneurysms rebleed at a rate of 1% per year, as do patients with subarachnoid hemorrhage of unknown etiology. The risk of rebleeding for AVM's is 3% a year.</jats:p>",
  "DOI": "10.3171/jns.1985.62.3.0321",
  "type": "journal-article",
  "created": {
    "date-parts": [
      [
        2009,
        5,
        8
      ]
    ],
    "date-time": "2009-05-08T16:19:17Z",
    "timestamp": 1241799557000
  },
  "page": "321-323",
  "source": "Crossref",
  "is-referenced-by-count": 236,
  "title": "The natural history of aneurysms and arteriovenous malformations",
  "prefix": "10.3171",
  "volume": "62",
  "author": [
    {
      "given": "John A.",
      "family": "Jane",
      "sequence": "first",
      "affiliation": []
    },
    {
      "given": "Neal F.",
      "family": "Kassell",
      "sequence": "additional",
      "affiliation": []
    },
    {
      "given": "James C.",
      "family": "Torner",
      "sequence": "additional",
      "affiliation": []
    },
    {
      "given": "H. Richard",
      "family": "Winn",
      "sequence": "additional",
      "affiliation": []
    }
  ],
  "member": "1754",
  "reference": [
    {
      "key": "b1",
      "series-title": "J Neurosurg",
      "doi-asserted-by": "publisher",
      "first-page": "331",
      "DOI": "10.3171/jns.1983.58.3.0331",
      "article-title": "Bleeding from cerebral arteriovenous malformations as part of their natural history.",
      "volume": "58",
      "author": "Graf",
      "year": "1983"
    },
    {
      "key": "b2",
      "series-title": "Stroke",
      "doi-asserted-by": "publisher",
      "first-page": "579",
      "DOI": "10.1161/01.STR.8.5.579",
      "article-title": "Intracranial aneurysms and subarachnoid hemorrhage \u2014 report on a randomized treatment study. IV-B. Regulated bedrest \u2014 statistical evaluation.",
      "volume": "8",
      "author": "Henderson",
      "year": "1977"
    },
    {
      "key": "b3",
      "series-title": "Clin Neurosurg",
      "doi-asserted-by": "publisher",
      "first-page": "176",
      "DOI": "10.1093/neurosurgery/24.CN_suppl_1.176",
      "article-title": "The natural history of intracranial aneurysms: rebleeding rates during the acute and long term period and implications for surgical management.",
      "volume": "24",
      "author": "Jane",
      "year": "1977"
    },
    {
      "key": "b4",
      "series-title": "Neurol Clin North Am",
      "doi-asserted-by": "publisher",
      "first-page": "73",
      "DOI": "10.1016/S0733-8619(18)31172-1",
      "article-title": "Review of the management of saccular aneurysms.",
      "volume": "1",
      "author": "Kassell",
      "year": "1983"
    },
    {
      "key": "b5",
      "series-title": "Neurosurgery",
      "doi-asserted-by": "publisher",
      "first-page": "479",
      "DOI": "10.1227/00006123-198311000-00001",
      "article-title": "Aneurysmal rebleeding: a preliminary report from the Cooperative Aneurysm Study.",
      "volume": "13",
      "author": "Kassell",
      "year": "1983"
    },
    {
      "key": "b6",
      "series-title": "Lancet",
      "first-page": "1203",
      "article-title": "Posterior-communicating aneurysms. A controlled trial of the conservative and surgical treatment of ruptured aneurysms of the internal carotid artery at or near the point of origin of the posterior communicating artery.",
      "volume": "1",
      "author": "McKissock",
      "year": "1960"
    },
    {
      "key": "b7",
      "series-title": "Arch Neurol",
      "doi-asserted-by": "publisher",
      "first-page": "1142",
      "DOI": "10.1001/archneur.1984.04050220036011",
      "article-title": "Cooperative study of intracranial aneurysms and subarachnoid hemorrhage: long-term prognostic study II. Ruptured intracranial aneurysms managed conservatively.",
      "volume": "41",
      "author": "Nishioka",
      "year": "1984"
    },
    {
      "key": "b8",
      "series-title": "Arch Neurol",
      "doi-asserted-by": "publisher",
      "first-page": "1147",
      "DOI": "10.1001/archneur.1984.04050220041012",
      "article-title": "Cooperative study of intracranial aneurysms and subarachnoid hemorrhage: long-term prognostic study III. Subarachnoid hemorrhage of undetermined etiology.",
      "volume": "41",
      "author": "Nishioka",
      "year": "1984"
    },
    {
      "key": "b9",
      "series-title": "J Neurosurg",
      "first-page": "226",
      "article-title": "Assessment of the natural history of anterior communicating aneurysms.",
      "volume": "21",
      "author": "Richardson",
      "year": "1964"
    },
    {
      "key": "b10",
      "series-title": "J Neurosurg",
      "doi-asserted-by": "publisher",
      "first-page": "280",
      "DOI": "10.3171/jns.1966.25.3.0280",
      "article-title": "The prediction of morbidity and mortality in anterior communicating aneurysms treated by proximal anterior cerebral ligation.",
      "volume": "25",
      "author": "Richardson",
      "year": "1966"
    },
    {
      "key": "b11",
      "series-title": "Arch Neurol",
      "doi-asserted-by": "publisher",
      "first-page": "172",
      "DOI": "10.1001/archneur.1966.00470080056008",
      "article-title": "Prognostic factors in the untreated course of posterior communicating aneurysms.",
      "volume": "14",
      "author": "Richardson",
      "year": "1966"
    },
    {
      "key": "b12",
      "series-title": "Aneurysmal Subarachnoid Hemorrhage. Report of the Cooperative Study.",
      "year": "1981"
    },
    {
      "key": "b13",
      "series-title": "Aneurysmal Subarachnoid Hemorrhage. Report of the Cooperative Study.",
      "first-page": "249",
      "article-title": "Statistical comparisons of end results of a randomized study",
      "author": "Torner",
      "year": "1981"
    },
    {
      "key": "b14",
      "series-title": "J Neurosurg",
      "doi-asserted-by": "publisher",
      "first-page": "642",
      "DOI": "10.3171/jns.1983.59.4.0642",
      "article-title": "The long-term outcome in patients with multiple aneurysms. Incidence of late hemorrhage and implications for treatment of incidental aneurysms.",
      "volume": "59",
      "author": "Winn",
      "year": "1983"
    },
    {
      "key": "b15",
      "series-title": "J Neurosurg",
      "doi-asserted-by": "publisher",
      "first-page": "727",
      "DOI": "10.3171/jns.1977.47.5.0727",
      "article-title": "Late morbidity and mortality of common carotid ligation for posterior communicating aneurysms. A comparison to conservative treatment.",
      "volume": "47",
      "author": "Winn",
      "year": "1977"
    },
    {
      "key": "b16",
      "series-title": "Ann Neurol",
      "doi-asserted-by": "publisher",
      "first-page": "358",
      "DOI": "10.1002/ana.410010407",
      "article-title": "The long-term prognosis in untreated cerebral aneurysms: I. The incidence of late hemorrhage in cerebral aneurysm: a 10-year evaluation of 364 patients.",
      "volume": "1",
      "author": "Winn",
      "year": "1977"
    },
    {
      "key": "b17",
      "series-title": "Ann Neurol",
      "doi-asserted-by": "publisher",
      "first-page": "418",
      "DOI": "10.1002/ana.410040506",
      "article-title": "The longterm prognosis in untreated cerebral aneurysms: II. Late morbidity and mortality.",
      "volume": "4",
      "author": "Winn",
      "year": "1978"
    },
    {
      "key": "b18",
      "series-title": "Stroke",
      "first-page": "121",
      "article-title": "Prevalence of asymptomatic incidental aneurysms: review of 4,568 arteriograms.",
      "volume": "14",
      "author": "Winn",
      "year": "1983"
    }
  ],
  "container-title": "Journal of Neurosurgery",
  "original-title": [],
  "link": [
    {
      "URL": "https://thejns.org/view/journals/j-neurosurg/62/3/article-p321.xml",
      "content-type": "text/html",
      "content-version": "vor",
      "intended-application": "text-mining"
    },
    {
      "URL": "https://thejns.org/downloadpdf/journals/j-neurosurg/62/3/article-p321.xml",
      "content-type": "text/html",
      "content-version": "vor",
      "intended-application": "syndication"
    },
    {
      "URL": "https://thejns.org/downloadpdf/journals/j-neurosurg/62/3/article-p321.xml",
      "content-type": "unspecified",
      "content-version": "vor",
      "intended-application": "similarity-checking"
    }
  ],
  "deposited": {
    "date-parts": [
      [
        2022,
        7,
        24
      ]
    ],
    "date-time": "2022-07-24T19:16:17Z",
    "timestamp": 1658690177000
  },
  "score": 1,
  "resource": {
    "primary": {
      "URL": "https://thejns.org/view/journals/j-neurosurg/62/3/article-p321.xml"
    }
  },
  "subtitle": [],
  "short-title": [],
  "issued": {
    "date-parts": [
      [
        1985,
        3
      ]
    ]
  },
  "references-count": 18,
  "journal-issue": {
    "issue": "3"
  },
  "URL": "http://dx.doi.org/10.3171/jns.1985.62.3.0321",
  "relation": {},
  "ISSN": [
    "0022-3085"
  ],
  "subject": [],
  "published": {
    "date-parts": [
      [
        1985,
        3
      ]
    ]
  }
}