Angioarchitectural features associated with hemorrhagic presentation in pediatric cerebral arteriovenous malformations
Background and objective To date, there have been few published studies examining the relationship between arteriovenous malformation (AVM) angioarchitecture and hemorrhagic presentation among children with cerebral AVMs. This study examines this relationship in this unique population, in whom sympt...
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| Veröffentlicht in: | Journal of neurointerventional surgery 2013-05, Vol.5 (3), p.191-195 |
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| creator | Ellis, Michael J Armstrong, Derek Vachhrajani, Shobhan Kulkarni, Abhaya V Dirks, Peter B Drake, James M Smith, Edward R Scott, R Michael Orbach, Darren B |
| description | Background and objective To date, there have been few published studies examining the relationship between arteriovenous malformation (AVM) angioarchitecture and hemorrhagic presentation among children with cerebral AVMs. This study examines this relationship in this unique population, in whom symptomatic presentation of cerebral AVM is the norm rather than the exception. Methods A cohort of children with AVMs from 2000 to 2011 were included. Predictors studied included patient age, gender and angioarchitectural features, including AVM location, nidus size and morphology, venous drainage, presence of venous outflow lesions and associated aneurysms. Predictors of hemorrhagic presentation were assessed using multivariate logistic regression. Results 135 children (70 males, mean age 10.1 years) were included. 86/135 (63.7%) children presented with hemorrhage, 18 (13.3%) with seizures, 17 (12.6%) with headaches or neurological deficits and 14 (10.4%) were asymptomatic. AVM location, morphology and the presence of associated aneurysm, venous ectasia, draining vein stenosis and single draining vein were not significantly associated factors. After multivariate analysis, AVM size (OR 0.57, 95% CI 0.43 to 0.77; p |
| doi_str_mv | 10.1136/neurintsurg-2011-010198 |
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Methods A cohort of children with AVMs from 2000 to 2011 were included. Predictors studied included patient age, gender and angioarchitectural features, including AVM location, nidus size and morphology, venous drainage, presence of venous outflow lesions and associated aneurysms. Predictors of hemorrhagic presentation were assessed using multivariate logistic regression. Results 135 children (70 males, mean age 10.1 years) were included. 86/135 (63.7%) children presented with hemorrhage, 18 (13.3%) with seizures, 17 (12.6%) with headaches or neurological deficits and 14 (10.4%) were asymptomatic. AVM location, morphology and the presence of associated aneurysm, venous ectasia, draining vein stenosis and single draining vein were not significantly associated factors. After multivariate analysis, AVM size (OR 0.57, 95% CI 0.43 to 0.77; p<0.01), exclusive deep venous drainage (OR 4.94, 95% CI 1.30 to 18.8; p=0.02) and infratentorial location (OR 9.94, 95% CI 1.71 to 51.76; p=0.01) were independently associated with hemorrhagic presentation. Conclusion Smaller AVM size, exclusive deep venous drainage and infratentorial location are specific angioarchitectural factors independently associated with initial hemorrhagic presentation in children with AVMs.</description><identifier>ISSN: 1759-8478</identifier><identifier>EISSN: 1759-8486</identifier><identifier>DOI: 10.1136/neurintsurg-2011-010198</identifier><identifier>PMID: 22416111</identifier><language>eng</language><publisher>BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd</publisher><subject>Adolescent ; Adults ; Age ; Arteriovenous Fistula - diagnostic imaging ; Arteriovenous Fistula - epidemiology ; Cerebral Angiography ; Cerebral Hemorrhage - diagnostic imaging ; Cerebral Hemorrhage - epidemiology ; Child ; Child, Preschool ; Cohort Studies ; Collaboration ; Decision making ; Female ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Intracranial Arteriovenous Malformations - diagnostic imaging ; Intracranial Arteriovenous Malformations - epidemiology ; Male ; Medical imaging ; Morphology ; Mortality ; Multivariate analysis ; Patients ; Pediatrics ; Retrospective Studies ; Sinuses ; Studies ; Veins & arteries ; Young Adult</subject><ispartof>Journal of neurointerventional surgery, 2013-05, Vol.5 (3), p.191-195</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Copyright: 2013 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b471t-572f1b2b12e99940eedfd8cf9bafff319c5660d299683e259f13601868e1e8393</citedby><cites>FETCH-LOGICAL-b471t-572f1b2b12e99940eedfd8cf9bafff319c5660d299683e259f13601868e1e8393</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://jnis.bmj.com/content/5/3/191.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://jnis.bmj.com/content/5/3/191.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,777,781,3183,23552,27905,27906,77349,77380</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22416111$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ellis, Michael J</creatorcontrib><creatorcontrib>Armstrong, Derek</creatorcontrib><creatorcontrib>Vachhrajani, Shobhan</creatorcontrib><creatorcontrib>Kulkarni, Abhaya V</creatorcontrib><creatorcontrib>Dirks, Peter B</creatorcontrib><creatorcontrib>Drake, James M</creatorcontrib><creatorcontrib>Smith, Edward R</creatorcontrib><creatorcontrib>Scott, R Michael</creatorcontrib><creatorcontrib>Orbach, Darren B</creatorcontrib><title>Angioarchitectural features associated with hemorrhagic presentation in pediatric cerebral arteriovenous malformations</title><title>Journal of neurointerventional surgery</title><addtitle>J NeuroIntervent Surg</addtitle><description>Background and objective To date, there have been few published studies examining the relationship between arteriovenous malformation (AVM) angioarchitecture and hemorrhagic presentation among children with cerebral AVMs. This study examines this relationship in this unique population, in whom symptomatic presentation of cerebral AVM is the norm rather than the exception. Methods A cohort of children with AVMs from 2000 to 2011 were included. Predictors studied included patient age, gender and angioarchitectural features, including AVM location, nidus size and morphology, venous drainage, presence of venous outflow lesions and associated aneurysms. Predictors of hemorrhagic presentation were assessed using multivariate logistic regression. Results 135 children (70 males, mean age 10.1 years) were included. 86/135 (63.7%) children presented with hemorrhage, 18 (13.3%) with seizures, 17 (12.6%) with headaches or neurological deficits and 14 (10.4%) were asymptomatic. AVM location, morphology and the presence of associated aneurysm, venous ectasia, draining vein stenosis and single draining vein were not significantly associated factors. After multivariate analysis, AVM size (OR 0.57, 95% CI 0.43 to 0.77; p<0.01), exclusive deep venous drainage (OR 4.94, 95% CI 1.30 to 18.8; p=0.02) and infratentorial location (OR 9.94, 95% CI 1.71 to 51.76; p=0.01) were independently associated with hemorrhagic presentation. Conclusion Smaller AVM size, exclusive deep venous drainage and infratentorial location are specific angioarchitectural factors independently associated with initial hemorrhagic presentation in children with AVMs.</description><subject>Adolescent</subject><subject>Adults</subject><subject>Age</subject><subject>Arteriovenous Fistula - diagnostic imaging</subject><subject>Arteriovenous Fistula - epidemiology</subject><subject>Cerebral Angiography</subject><subject>Cerebral Hemorrhage - diagnostic imaging</subject><subject>Cerebral Hemorrhage - epidemiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>Collaboration</subject><subject>Decision making</subject><subject>Female</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Intracranial Arteriovenous Malformations - diagnostic imaging</subject><subject>Intracranial Arteriovenous Malformations - epidemiology</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Morphology</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Retrospective Studies</subject><subject>Sinuses</subject><subject>Studies</subject><subject>Veins & arteries</subject><subject>Young Adult</subject><issn>1759-8478</issn><issn>1759-8486</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkUuP1DAQhCMEYpeFvwCRuHAJuO3Ejo-rES9ptWglHkfLcdozHhJ7sJ0F_j0esowQJ07dUn9VKnVV1TMgLwEYf-Vxic7ntMRtQwlAQ4CA7O9V5yA62fRtz--fdtGfVY9S2hPCRSe6h9UZpS1wADivbi_91gUdzc5lNHmJeqot6rJgqnVKwTidcay_u7yrdziHGHd660x9KAD6rLMLvna-PuBYyFguBiMORx8dM0YXbtGHJdWznmyI829Belw9sHpK-ORuXlSf3rz-uHnXXH14-35zedUMrYDcdIJaGOgAFKWULUEc7dgbKwdtrWUgTcc5GamUvGdIO2nLcwj0vEfAnkl2Ub1YfQ8xfFswZTW7ZHCatMcSSgGjHFpGRVvQ5_-g-7BEX9IpEMWRQCd5ocRKmRhSimjVIbpZx58KiDpWo_6qRh2rUWs1Rfn0zn8ZZhxPuj9dFKBZAZcy_jjddfyquGCiU9efN4p9uRakvblRm8LTlR_m_X-n-AXVLbB6</recordid><startdate>201305</startdate><enddate>201305</enddate><creator>Ellis, Michael J</creator><creator>Armstrong, Derek</creator><creator>Vachhrajani, Shobhan</creator><creator>Kulkarni, Abhaya V</creator><creator>Dirks, Peter B</creator><creator>Drake, James M</creator><creator>Smith, Edward R</creator><creator>Scott, R Michael</creator><creator>Orbach, Darren B</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201305</creationdate><title>Angioarchitectural features associated with hemorrhagic presentation in pediatric cerebral arteriovenous malformations</title><author>Ellis, Michael J ; Armstrong, Derek ; Vachhrajani, Shobhan ; Kulkarni, Abhaya V ; Dirks, Peter B ; Drake, James M ; Smith, Edward R ; Scott, R Michael ; Orbach, Darren B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b471t-572f1b2b12e99940eedfd8cf9bafff319c5660d299683e259f13601868e1e8393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adults</topic><topic>Age</topic><topic>Arteriovenous Fistula - diagnostic imaging</topic><topic>Arteriovenous Fistula - epidemiology</topic><topic>Cerebral Angiography</topic><topic>Cerebral Hemorrhage - diagnostic imaging</topic><topic>Cerebral Hemorrhage - epidemiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>Collaboration</topic><topic>Decision making</topic><topic>Female</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Intracranial Arteriovenous Malformations - diagnostic imaging</topic><topic>Intracranial Arteriovenous Malformations - epidemiology</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Morphology</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Retrospective Studies</topic><topic>Sinuses</topic><topic>Studies</topic><topic>Veins & arteries</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ellis, Michael J</creatorcontrib><creatorcontrib>Armstrong, Derek</creatorcontrib><creatorcontrib>Vachhrajani, Shobhan</creatorcontrib><creatorcontrib>Kulkarni, Abhaya V</creatorcontrib><creatorcontrib>Dirks, Peter B</creatorcontrib><creatorcontrib>Drake, James M</creatorcontrib><creatorcontrib>Smith, Edward R</creatorcontrib><creatorcontrib>Scott, R Michael</creatorcontrib><creatorcontrib>Orbach, Darren B</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurointerventional surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ellis, Michael J</au><au>Armstrong, Derek</au><au>Vachhrajani, Shobhan</au><au>Kulkarni, Abhaya V</au><au>Dirks, Peter B</au><au>Drake, James M</au><au>Smith, Edward R</au><au>Scott, R Michael</au><au>Orbach, Darren B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Angioarchitectural features associated with hemorrhagic presentation in pediatric cerebral arteriovenous malformations</atitle><jtitle>Journal of neurointerventional surgery</jtitle><addtitle>J NeuroIntervent Surg</addtitle><date>2013-05</date><risdate>2013</risdate><volume>5</volume><issue>3</issue><spage>191</spage><epage>195</epage><pages>191-195</pages><issn>1759-8478</issn><eissn>1759-8486</eissn><abstract>Background and objective To date, there have been few published studies examining the relationship between arteriovenous malformation (AVM) angioarchitecture and hemorrhagic presentation among children with cerebral AVMs. This study examines this relationship in this unique population, in whom symptomatic presentation of cerebral AVM is the norm rather than the exception. Methods A cohort of children with AVMs from 2000 to 2011 were included. Predictors studied included patient age, gender and angioarchitectural features, including AVM location, nidus size and morphology, venous drainage, presence of venous outflow lesions and associated aneurysms. Predictors of hemorrhagic presentation were assessed using multivariate logistic regression. Results 135 children (70 males, mean age 10.1 years) were included. 86/135 (63.7%) children presented with hemorrhage, 18 (13.3%) with seizures, 17 (12.6%) with headaches or neurological deficits and 14 (10.4%) were asymptomatic. AVM location, morphology and the presence of associated aneurysm, venous ectasia, draining vein stenosis and single draining vein were not significantly associated factors. After multivariate analysis, AVM size (OR 0.57, 95% CI 0.43 to 0.77; p<0.01), exclusive deep venous drainage (OR 4.94, 95% CI 1.30 to 18.8; p=0.02) and infratentorial location (OR 9.94, 95% CI 1.71 to 51.76; p=0.01) were independently associated with hemorrhagic presentation. Conclusion Smaller AVM size, exclusive deep venous drainage and infratentorial location are specific angioarchitectural factors independently associated with initial hemorrhagic presentation in children with AVMs.</abstract><cop>BMA House, Tavistock Square, London, WC1H 9JR</cop><pub>BMJ Publishing Group Ltd</pub><pmid>22416111</pmid><doi>10.1136/neurintsurg-2011-010198</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adults Age Arteriovenous Fistula - diagnostic imaging Arteriovenous Fistula - epidemiology Cerebral Angiography Cerebral Hemorrhage - diagnostic imaging Cerebral Hemorrhage - epidemiology Child Child, Preschool Cohort Studies Collaboration Decision making Female Hemorrhage Humans Infant Infant, Newborn Intracranial Arteriovenous Malformations - diagnostic imaging Intracranial Arteriovenous Malformations - epidemiology Male Medical imaging Morphology Mortality Multivariate analysis Patients Pediatrics Retrospective Studies Sinuses Studies Veins & arteries Young Adult |
| title | Angioarchitectural features associated with hemorrhagic presentation in pediatric cerebral arteriovenous malformations |
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