Document Detail


Incident hemorrhage risk of brain arteriovenous malformations located in the arterial borderzones.
MedLine Citation:
PMID:  11022065     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: We sought to assess the relative risk of hemorrhagic presentation of brain arteriovenous malformations (AVMs) located in the arterial borderzone territories. METHODS: The 464 consecutive, prospectively enrolled patients from the New York AVM Databank were analyzed. AVM borderzone location was coded positive when the malformation was supplied by branches of at least 2 of the major circle of Willis arteries (anterior, middle, and/or posterior cerebral arteries). AVMs fed by branches of only 1 major pial or any other single artery served as a comparison group. Clinical presentation (diagnostic event) was categorized as (1) intracranial hemorrhage, proven by brain imaging, or (2) seizure, focal neurological deficit, headache, or other event with no signs of AVM hemorrhage on brain imaging. RESULTS: In 48% (n=222) of the patients, AVMs were located in the arterial borderzone territories; in 52% (n=242) a non-borderzone location was found. Hemorrhage was the presenting symptom in 44% (n=205); 28% (n=132) presented with seizures, 11% (n=52) with headaches, 7% (n=34) with a neurological deficit, and 9% (n=41) with other or no AVM-related symptoms. The frequency of incident AVM hemorrhage was significantly lower in borderzone AVMs (27%, n=61) than in non-borderzone malformations (60%, n=144; P:<0.001). This difference remained significant in a multivariate model controlling for age, sex, AVM size, deep venous drainage, and presence of aneurysms (odds ratio, 0.4; 95% CI, 0.25 to 0.66). CONCLUSIONS: Our findings suggest that borderzone location is an independent determinant for a lower risk of AVM hemorrhage at initial presentation.
Authors:
C Stapf; J P Mohr; R R Sciacca; A Hartmann; B D Aagaard; J Pile-Spellman; H Mast
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  31     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2000-10-13     Completed Date:  2000-10-26     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2365-8     Citation Subset:  IM    
Affiliation:
Stroke Center/Neurological Institute, Departments of Interventional Neuroradiology, Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA. cs585@columbia.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Brain / blood supply,  pathology
Cerebral Angiography
Cerebral Hemorrhage / diagnosis*,  etiology*
Female
Headache / etiology
Humans
Intracranial Arteriovenous Malformations / complications*,  radiography
Logistic Models
Male
Multivariate Analysis
Prospective Studies
Risk Assessment
Seizures / etiology
Sex Factors
Grant Support
ID/Acronym/Agency:
R01-NS-34949/NS/NINDS NIH HHS

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


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