Abstract
Background and Aim: Cavernous malformations are low-flow vascular malformations of the central nervous
system. Brainstem location and prior hemorrhage increase future hemorrhage risk. We
sought to determine the influence of physical activity on hemorrhage risk. Methods: Consecutive patients with radiologically confirmed cavernous malformations participated
in a prospective registry with structured, baseline interviews, surveys, and examinations.
Patients were asked about unusual events prior to initial clinical presentation. Medical
records and MRIs were reviewed. Patients were surveyed about their physical activity
after receiving their diagnosis. Annual follow-up surveys to patients ascertained new hemorrhages.
Follow-up terminated at last follow-up, hemorrhage, surgery, or death. Univariate
analysis assessed the risk of physical activities on prospective hemorrhage. Results: Of 195 patients, 117 (60%) were female. Median diagnosis age was 41 years. After
diagnosis, 103 (52.8%) patients returned the physical activity survey (cerebral n = 100;
spine n = 3). Over 539.4 patient years, 23 had a prospective hemorrhage. Five patients
were removed from analysis because they had less than 6 weeks of physical-activity
exposure before censor. The remaining 98 had no difference in prospective hemorrhage
risk than those patients participating greater than or equal to 3 times monthly in
walking, running, greater than 20-pound or less than 20-pound weight lifting, or noncontact
sports. Few (n = 5) reported contact-sport participation, scuba diving (n = 2), or
high-altitude climbing (n = 1) greater than 3 times monthly. Conclusions: Aerobic activity and noncontact sports do not increase hemorrhage risk in cerebral
cavernous malformation; patients should not be restricted. Less is known about contact
sports, high-altitude climbing, scuba diving, and those with spinal-cord cavernous
malformation.
Key Words
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Article info
Publication history
Accepted:
December 22,
2019
Received in revised form:
November 18,
2019
Received:
September 10,
2019
Footnotes
Funding: This publication was supported by Grant Number UL1 TR002377 from the National Center for Advancing Translational Sciences (NCATS). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104629
Copyright
© 2019 Elsevier Inc. All rights reserved.
