| Association of infratentorial brain arteriovenous malformations with hemorrhage at initial presentation. | |
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MedLine Citation:
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PMID: 14752127 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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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:
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Title: Stroke; a journal of cerebral circulation Volume: 35 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2004 Mar |
Date Detail:
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Created Date: 2004-02-27 Completed Date: 2004-04-30 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 660-3 Citation Subset: IM |
Affiliation:
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Stroke Center, Neurological Institute, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. akhaw@neuro.columbia.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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R01 40792-01//PHS HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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