Influence of patient age on angioarchitecture of brain arteriovenous malformations.

Autor:	Hetts SW; From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging steven.hetts@ucsf.edu., Cooke DL; From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging., Nelson J; Center for Cerebrovascular Research (J.N., H.K.), Department of Anesthesia and Perioperative Care., Gupta N; Division of Pediatric Neurosurgery (N.G.)Department of Pediatrics (N.G., H.F.), University of California, San Francisco, San Francisco, California., Fullerton H; Division of Child Neurology (H.F.), Department of NeurologyDepartment of Pediatrics (N.G., H.F.), University of California, San Francisco, San Francisco, California., Amans MR; From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging., Narvid JA; From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging., Moftakhar P; From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging., McSwain H; From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging., Dowd CF; From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging., Higashida RT; From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging., Halbach VV; From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging., Lawton MT; Division of Cerebrovascular Neurosurgery (M.T.L.), Department of Neurological Surgery., Kim H; Center for Cerebrovascular Research (J.N., H.K.), Department of Anesthesia and Perioperative Care.
Jazyk:	angličtina
Zdroj:	AJNR. American journal of neuroradiology [AJNR Am J Neuroradiol] 2014 Jul; Vol. 35 (7), pp. 1376-80. Date of Electronic Publication: 2014 Mar 13.
DOI:	10.3174/ajnr.A3886
Abstrakt:	Background and Purpose: The imaging characteristics and modes of presentation of brain AVMs may vary with patient age. Our aim was to determine whether clinical and angioarchitectural features of brain AVMs differ between children and adults. Materials and Methods: A prospectively collected institutional data base of all patients diagnosed with brain AVMs since 2001 was queried. Demographic, clinical, and angioarchitecture information was summarized and analyzed with univariable and multivariable models. Results: Results often differed when age was treated as a continuous variable as opposed to dividing subjects into children (18 years or younger; n = 203) versus adults (older than 18 years; n = 630). Children were more likely to present with AVM hemorrhage than adults (59% versus 41%, P < .001). Although AVMs with a larger nidus presented at younger ages (mean of 26.8 years for >6 cm compared with 37.1 years for <3 cm), this feature was not significantly different between children and adults (P = .069). Exclusively deep venous drainage was more common in younger subjects when age was treated continuously (P = .04) or dichotomized (P < .001). Venous ectasia was more common with increasing age (mean, 39.4 years with ectasia compared with 31.1 years without ectasia) and when adults were compared with children (52% versus 35%, P < .001). Patients with feeding artery aneurysms presented at a later average age (44.1 years) than those without such aneurysms (31.6 years); this observation persisted when comparing children with adults (13% versus 29%, P < .001). Conclusions: Although children with brain AVMs were more likely to come to clinical attention due to hemorrhage than adults, venous ectasia and feeding artery aneurysms were under-represented in children, suggesting that these particular high-risk features take time to develop. (© 2014 by American Journal of Neuroradiology.)
Databáze:	MEDLINE
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