Document Detail


Association of infratentorial brain arteriovenous malformations with hemorrhage at initial presentation.
MedLine Citation:
PMID:  14752127     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The goal of this study was to analyze the association of hemorrhagic presentation with infratentorial brain arteriovenous malformations (AVMs). METHODS: The 623 consecutive, prospectively enrolled patients from the Columbia AVM Databank were analyzed in a cross-sectional study. Clinical presentation (diagnostic event) was categorized as intracranial hemorrhage or nonhemorrhagic presentation. From brain imaging and cerebral angiography, AVM location was classified as either infratentorial or supratentorial. Univariate and multivariate statistical models were applied to test the effect of age, sex, AVM size and location, venous drainage pattern, and associated (ie, feeding artery or intranidal) arterial aneurysms on the likelihood of hemorrhage at initial AVM presentation. RESULTS: Of the 623 patients, 72 (12%) had an infratentorial and 551 (88%) had a supratentorial AVM. Intracranial hemorrhage was the presenting symptom in 283 patients (45%), and infratentorial AVM location was significantly more frequent (18%) among patients who bled initially (6%; odds ratio [OR], 3.60; 95% confidence interval [CI], 2.09 to 6.20). This difference remained significant (OR, 1.99; 95% CI, 1.07 to 3.69) in the multivariate logistic regression model controlling for age, sex, AVM size, deep venous drainage, and associated arterial aneurysms. In the same model, the effect of other established determinants for AVM hemorrhage--ie, AVM size (in 1-mm increments; OR, 0.95; 95% CI, 0.94 to 0.96), deep venous drainage (OR, 3.09; 95% CI, 1.87 to 5.12), and associated aneurysms (OR, 2.78; 95% CI, 1.76 to 4.40)--remained significant. CONCLUSIONS: Our findings suggest that infratentorial AVM location is independently associated with hemorrhagic AVM presentation.
Authors:
A V Khaw; J P Mohr; R R Sciacca; H C Schumacher; A Hartmann; J Pile-Spellman; H Mast; C Stapf
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2004-01-29
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  35     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-02-27     Completed Date:  2004-04-30     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  660-3     Citation Subset:  IM    
Affiliation:
Stroke Center, Neurological Institute, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. akhaw@neuro.columbia.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Brain Stem / blood supply
Cerebellum / blood supply
Cerebral Angiography
Comorbidity
Cross-Sectional Studies
Female
Humans
Intracranial Arteriovenous Malformations / diagnosis*,  epidemiology
Intracranial Hemorrhages / diagnosis*,  epidemiology
Logistic Models
Male
Multivariate Analysis
New York / epidemiology
Odds Ratio
Prospective Studies
Risk Assessment
Risk Factors
Sex Factors
Grant Support
ID/Acronym/Agency:
R01 40792-01//PHS HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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