Feeding artery pressure and venous drainage pattern are primary determinants of hemorrhage from cerebral arteriovenous malformations.


PURPOSE:The purpose of this study was to define the influence of feeding mean arterial pressure (FMAP) in conjunction with other morphological or clinical risk factors in determining the probability of hemorrhagic presentation in patients with cerebral arteriovenous malformations (AVMs). METHODS:Clinical and angiographic data from 340 patients with cerebral AVMs from a prospective database were reviewed. Patients were identified in whom FMAP was measured during superselective angiography. Additional variables analyzed included AVM size, location, nidus border, presence of aneurysms, and arterial supply and venous drainage patterns. The presence of arterial aneurysms was also correlated with site of bleeding on imaging studies. RESULTS:By univariate analysis, exclusively deep venous drainage, periventricular venous drainage, posterior fossa location, and FMAP predicted hemorrhagic presentation. When we used stepwise multiple logistic regression analysis in the cohort that had FMAP measurements (n = 129), only exclusively deep venous drainage (odds ratio [OR], 3.7; 95% confidence interval [CI], 1.4 to 9.8) and FMAP (OR, 1.4 per 10 mm Hg increase; 95% CI, 1.1 to 1.8) were independent predictors (P < 0.01) of hemorrhagic presentation; size, location, and the presence of aneurysms were not independent predictors. There was also no association (P = 0.23) between the presence of arterial aneurysms and subarachnoid hemorrhage. CONCLUSIONS:High arterial input pressure (FMAP) and venous outflow restriction (exclusively deep venous drainage) were the most powerful risk predictors for hemorrhagic AVM presentation. Our findings suggest that high intranidal pressure is more important than factors such as size, location, and the presence of arterial aneurysms in the pathophysiology of AVM hemorrhage.






Duong DH,Young WL,Vang MC,Sciacca RR,Mast H,Koennecke HC,Hartmann A,Joshi S,Mohr JP,Pile-Spellman J




Has Abstract


1998-06-01 00:00:00














  • Cardiac sources of embolism in patients with pial artery infarcts and lacunar lesions.

    abstract:BACKGROUND AND PURPOSE:On the assumption that the majority of lacunes are caused by small-vessel diseases and that pial artery infarcts arise from cardio-embolic or large-vessel diseases, 194 patients from the Berlin Cerebral Ischemia Data Bank with either lacunar or pial artery infarcts were analyzed for the frequency...


    pub_type: 杂志文章


    authors: Mast H,Thompson JL,Völler H,Mohr JP,Marx P

    更新日期:1994-04-01 00:00:00

  • Correlation between somatosensory evoked potentials and neuronal ischemic changes following middle cerebral artery occlusion.

    abstract::In an attempt to determine the usefulness of evoked potentials as a measure of focal cerebral ischemia, we examined somatosensory evoked potentials (SEP's) and morphological neuronal changes in cats following unilateral middle cerebral artery (MCA) occlusion. Fifteen adult cats underwent transorbital occlusion of the ...


    pub_type: 杂志文章


    authors: Steinberg GK,Gelb AW,Lam AM,Manninen PH,Peerless SJ,Rassi Neto A,Floyd P

    更新日期:1986-11-01 00:00:00

  • Malignant emboli on transcranial Doppler during carotid stenting predict postprocedure diffusion-weighted imaging lesions.

    abstract:BACKGROUND AND PURPOSE:Carotid angioplasty and stenting (CAS) has a higher incidence of periprocedural stroke compared with endarterectomy. Identifying CAS steps with the highest likelihood of embolization may have important implications. We evaluated CAS safety by correlating the findings of procedural transcranial Do...


    pub_type: 杂志文章


    authors: Almekhlafi MA,Demchuk AM,Mishra S,Bal S,Menon BK,Wiebe S,Clement FM,Wong JH,Hill MD,Goyal M

    更新日期:2013-05-01 00:00:00

  • Reliability of the modified Rankin Scale across multiple raters: benefits of a structured interview.

    abstract:BACKGROUND AND PURPOSE:The modified Rankin Scale (mRS) is widely used to assess global outcome after stroke. The aim of the study was to examine rater variability in assessing functional outcomes using the conventional mRS, and to investigate whether use of a structured interview (mRS-SI) reduced this variability. MET...


    pub_type: 杂志文章,多中心研究


    authors: Wilson JT,Hareendran A,Hendry A,Potter J,Bone I,Muir KW

    更新日期:2005-04-01 00:00:00

  • Magnetic resonance imaging and dynamic CT scan in cervical artery dissections.

    abstract:BACKGROUND AND PURPOSE:The typical magnetic resonance imaging picture of arterial dissection, namely, a narrowed eccentric signal void surrounded by a semilunar signal hyper-intensity (corresponding to the mural hematoma) on T1- and T2-weighted images, has been repeatedly reported, but the sensitivity of magnetic reson...


    pub_type: 杂志文章


    authors: Zuber M,Meary E,Meder JF,Mas JL

    更新日期:1994-03-01 00:00:00

  • Hemolysate-induced contraction in smooth muscle cells of the guinea pig basilar artery.

    abstract::The hemolysate (10(-5)-10(-2) times dilution; original hemoglobin concentration was 0.83 +/- 0.10 X 10(-3)M) evoked the contraction in a dose dependent manner, and this contraction was composed of low and high sensitive responses as estimated from the Eadie-Hofstee's plot. Indomethacin (10(-7)-10(-5)M) inhibited the l...


    pub_type: 杂志文章


    authors: Fujiwara S,Kuriyama H

    更新日期:1984-05-01 00:00:00

  • Determinants of early recurrence of cerebral infarction. The Stroke Data Bank.

    abstract::We studied 1,273 patients with ischemic cerebral infarction who were entered into the Stroke Data Bank, a prospective, observational study involving four university hospitals and the Biometry and Field Studies Branch of the National Institute of Neurological Disorders and Stroke. Forty patients had noniatrogenic recur...


    pub_type: 杂志文章


    authors: Sacco RL,Foulkes MA,Mohr JP,Wolf PA,Hier DB,Price TR

    更新日期:1989-08-01 00:00:00

  • Ischemic stroke subtypes: a population-based study of incidence and risk factors.

    abstract:BACKGROUND AND PURPOSE:There is scant population-based information on incidence and risk factors for ischemic stroke subtypes. METHODS:We identified all 454 residents of Rochester, Minn, with a first ischemic stroke between 1985 and 1989 from the Rochester Epidemiology Project medical records linkage system. We used S...


    pub_type: 杂志文章


    authors: Petty GW,Brown RD Jr,Whisnant JP,Sicks JD,O'Fallon WM,Wiebers DO

    更新日期:1999-12-01 00:00:00

  • Levels of anti-inflammatory cytokines and neurological worsening in acute ischemic stroke.

    abstract:BACKGROUND:Mechanisms involved in stroke progression are incompletely understood. Ischemic brain injury is characterized by acute local inflammatory response mediated by cytokines. Anti-inflammatory cytokines act in a feedback loop to inhibit continued proinflammatory cytokine production. We assessed the implication of...


    pub_type: 临床试验,杂志文章


    authors: Vila N,Castillo J,Dávalos A,Esteve A,Planas AM,Chamorro A

    更新日期:2003-03-01 00:00:00

  • Low-Dose Tirofiban Improves Functional Outcome in Acute Ischemic Stroke Patients Treated With Endovascular Thrombectomy.

    abstract:BACKGROUND AND PURPOSE:Chinese patients largely experience acute ischemic stroke (AIS) because of large artery atherosclerosis rather than cardioembolism, and whether tirofiban is safe and effective in these patients treated with endovascular thrombectomy (ET) is unknown. This study evaluated the safety and efficacy of...


    pub_type: 杂志文章


    authors: Zhao W,Che R,Shang S,Wu C,Li C,Wu L,Chen J,Duan J,Song H,Zhang H,Ling F,Wang Y,Liebeskind D,Feng W,Ji X

    更新日期:2017-12-01 00:00:00

  • Collagen type I alpha2 (COL1A2) is the susceptible gene for intracranial aneurysms.

    abstract:BACKGROUND AND PURPOSE:The collagen alpha2(I) gene (COL1A2) on chromosome 7q22.1, a positional and functional candidate for intracranial aneurysm (IA), was extensively screened for susceptibility in Japanese IA patients. METHODS:Twenty-one single nucleotide polymorphisms (SNPs) of COL1A2 were genotyped in genomic DNA ...


    pub_type: 杂志文章


    authors: Yoneyama T,Kasuya H,Onda H,Akagawa H,Hashiguchi K,Nakajima T,Hori T,Inoue I

    更新日期:2004-02-01 00:00:00

  • Effects of posture on right-to-left shunt detection by contrast transcranial doppler.

    abstract:BACKGROUND AND PURPOSE:There is controversy about the optimal patient position for the detection of right-to-left shunt (RLS). The study was performed to investigate which patient position best detects RLS during contrast-enhanced transcranial Doppler. METHODS:We prospectively evaluated consecutive patients with ische...


    pub_type: 杂志文章


    authors: Agustin SJ,Yumul MP,Kalaw AJ,Teo BC,Eng J,Phua Z,Singh R,Gan RN,Venketasubramanian N

    更新日期:2011-08-01 00:00:00

  • Neuroprotective effects of adenosine monophosphate-activated protein kinase inhibition and gene deletion in stroke.

    abstract:BACKGROUND AND PURPOSE:5' adenosine monophosphate-dependent protein kinase (AMPK) acts as a metabolic sensor. AMPK is elevated under ischemic conditions, but the role of AMPK in ischemic brain remains controversial. In this study, we examined the effects of AMPK inhibition using both pharmacological and genetic approac...


    pub_type: 杂志文章


    authors: Li J,Zeng Z,Viollet B,Ronnett GV,McCullough LD

    更新日期:2007-11-01 00:00:00

  • Outcomes after carotid artery stenting and endarterectomy in the Medicare population.

    abstract:BACKGROUND AND PURPOSE:Carotid artery stenting (CAS) is an alternative to carotid endarterectomy (CEA) for stroke prevention. The value of this therapy relative to CEA remains uncertain. METHODS:In 10 958 Medicare patients aged 66 years or older between 2004 and 2006, we analyzed in-hospital, 1-year stroke, myocardial...


    pub_type: 杂志文章


    authors: Wang FW,Esterbrooks D,Kuo YF,Mooss A,Mohiuddin SM,Uretsky BF

    更新日期:2011-07-01 00:00:00

  • A comparison of the costs and survival of hospital-admitted stroke patients across Europe.

    abstract:BACKGROUND AND PURPOSE:Policy makers require evidence on the costs and outcomes of different ways of organizing stroke care. This study compared the costs and survival of different ways of providing stroke care. METHODS:Hospitalized stroke patients from 13 European centers were included, with demographic, case-mix, an...


    pub_type: 杂志文章,多中心研究


    authors: Grieve R,Hutton J,Bhalla A,Rastenytë D,Ryglewicz D,Sarti C,Lamassa M,Giroud M,Dundas R,Wolfe CD

    更新日期:2001-07-01 00:00:00

  • Cost-Effectiveness of a Multifaceted Quality Improvement Intervention for Acute Ischemic Stroke in China.

    abstract::Background and Purpose- Multifaceted quality improvement interventions of stroke care have been shown to improve hospital personnel adherence to evidence-based performance measures and subsequent stroke outcomes. This study aimed to evaluate the cost-effectiveness of a multifaceted quality improvement intervention for...


    pub_type: 杂志文章


    authors: Pan Y,Zhang L,Li Z,Meng X,Wang Y,Li H,Liu L,Wang Y

    更新日期:2020-04-01 00:00:00

  • Cigarette smoking and risk of stroke and its subtypes among middle-aged Japanese men and women: the JPHC Study Cohort I.

    abstract:BACKGROUND AND PURPOSE:We examined sex-specific relationships of smoking with risk of total stroke and stroke subtypes in Asian populations because of the limited data available. METHODS:A total of 19,782 men and 21,500 women aged 40 to 59 years who were free of prior diagnosis of stroke, coronary heart disease, or ca...


    pub_type: 杂志文章


    authors: Mannami T,Iso H,Baba S,Sasaki S,Okada K,Konishi M,Tsugane S,Japan Public Health Center-Based Prospective Study on Cancer and Cardiovascular Disease Group.

    更新日期:2004-06-01 00:00:00

  • Retrospective Methods Analysis of Semiautomated Intracerebral Hemorrhage Volume Quantification From a Selection of the STICH II Cohort (Early Surgery Versus Initial Conservative Treatment in Patients With Spontaneous Supratentorial Lobar Intracerebral Hae

    abstract:BACKGROUND AND PURPOSE:The ABC/2 method for calculating intracerebral hemorrhage (ICH) volume has been well validated. However, the formula, derived from the volume of an ellipse, assumes the shape of ICH is elliptical. We sought to compare the agreement of the ABC/2 formula with other methods through retrospective ana...


    pub_type: 杂志文章


    authors: Haley MD,Gregson BA,Mould WA,Hanley DF,Mendelow AD

    更新日期:2018-02-01 00:00:00

  • Is occult atrial disorder a frequent cause of non-hemorrhagic stroke? Long-term ECG in 86 patients.

    abstract::To assess the importance of occult atrial disorder with possible embolization as a cause of non-hemorrhagic stroke, 68 patients with neurologic symptoms lasting 24 hours or more and 18 patients with transient ischemic attacks were examined by long-term electrocardiographic recording (LTER). Lacking matched controls we...


    pub_type: 杂志文章


    authors: Abdon NJ,Zettervall O,Carlson J,Berglund S,Sterner G,Tejler L,Turesson I

    更新日期:1982-11-01 00:00:00

  • High-sensitivity C-reactive protein and lipoprotein-associated phospholipase A2 stability before and after stroke and myocardial infarction.

    abstract:BACKGROUND AND PURPOSE:High-sensitivity C-reactive protein (hsCRP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) are hypothesized to be biomarkers of systemic inflammation and risk of myocardial infarction (MI) and stroke. Little is known, however, about the stability of these markers over time, and in particul...


    pub_type: 杂志文章


    authors: Elkind MS,Leon V,Moon YP,Paik MC,Sacco RL

    更新日期:2009-10-01 00:00:00

  • Cathepsin and calpain inhibitor E64d attenuates matrix metalloproteinase-9 activity after focal cerebral ischemia in rats.

    abstract:BACKGROUND AND PURPOSE:Matrix metalloproteinases (MMPs) and cysteine proteases (calpain and cathepsin B) play an important role in cell death and are upregulated after focal cerebral ischemia. Because there is a significant interaction between MMP-9 with calpain and cathepsin B, we investigated the role of E64d (a calp...


    pub_type: 杂志文章


    authors: Tsubokawa T,Solaroglu I,Yatsushige H,Cahill J,Yata K,Zhang JH

    更新日期:2006-07-01 00:00:00

  • Elevated white blood cell count and carotid plaque thickness : the northern manhattan stroke study.

    abstract:BACKGROUND AND PURPOSE:Elevated leukocyte count has been associated with cardiovascular and cerebrovascular disease in several epidemiological studies. We sought to determine whether white blood cell count (WBC) is associated with carotid plaque thickness in a stroke-free, multiethnic cohort. METHODS:For this cross-se...


    pub_type: 杂志文章


    authors: Elkind MS,Cheng J,Boden-Albala B,Paik MC,Sacco RL,Northern Manhattan Stroke Study.

    更新日期:2001-04-01 00:00:00

  • Carotid artery thrombus associated with severe iron-deficiency anemia and thrombocytosis.

    abstract:BACKGROUND:Thrombus within the carotid artery usually occurs in vessels with severe atherosclerotic disease and may embolize to cause transient ischemic attacks and cerebral infarctions. The risk factors for carotid artery thrombus formation in the absence of atherosclerosis are not well characterized. A case series is...


    pub_type: 杂志文章


    authors: Akins PT,Glenn S,Nemeth PM,Derdeyn CP

    更新日期:1996-05-01 00:00:00

  • Regional cerebral blood flow in the anesthetized mouse as measured by local hydrogen clearance.

    abstract::Platinum microelectrodes were used to measure H2 clearance in mouse brain, and the clearance curves were used to calculate regional cerebral blood flow (rCBF). The curves were usually biexponential, whether or not electrode placement was confined to the cortex. When calculated by the height over area method, rCBF in a...


    pub_type: 杂志文章


    authors: Rosenblum WI

    更新日期:1977-01-01 00:00:00

  • Timing of Percutaneous Endoscopic Gastrostomy for Acute Ischemic Stroke: An Observational Study From the US Nationwide Inpatient Sample.

    abstract:BACKGROUND AND PURPOSE:Stroke guidelines recommend time-limited trials of nasogastric feeding prior to percutaneous endoscopic gastrostomy (PEG) tube placement. We sought to describe timing of PEG placement and identify factors associated with early PEG for acute ischemic stroke. METHODS:We designed a retrospective ob...


    pub_type: 杂志文章


    authors: George BP,Kelly AG,Albert GP,Hwang DY,Holloway RG

    更新日期:2017-02-01 00:00:00

  • Pharmacologic interventions for stroke: looking beyond the thrombolysis time window into the penumbra with biomarkers, not a stopwatch.

    abstract:BACKGROUND AND PURPOSE:The majority of pharmacological agents for stroke were developed based on the assumption that neurological deficits will be reduced upon the successful interruption of biochemical mechanisms leading to neuronal death. Despite significant evidence of preclinical efficacy, none of these agents succ...


    pub_type: 杂志文章,评审


    authors: Chavez JC,Hurko O,Barone FC,Feuerstein GZ

    更新日期:2009-10-01 00:00:00

  • Diffusion- and perfusion-weighted magnetic resonance imaging of the brain before and after coronary artery bypass grafting surgery.

    abstract:BACKGROUND AND PURPOSE:Coronary artery bypass grafting (CABG) is a frequently performed surgical procedure that can be associated with neurological complications. Some studies have demonstrated that new focal brain lesions, detected by MRI, can develop after CABG. Furthermore, it has been suggested that the presence of...


    pub_type: 临床试验,杂志文章


    authors: Restrepo L,Wityk RJ,Grega MA,Borowicz L Jr,Barker PB,Jacobs MA,Beauchamp NJ,Hillis AE,McKhann GM

    更新日期:2002-12-01 00:00:00

  • Ultrasonic Doppler assessment of hemodynamics in gradual carotid ligation.

    abstract::Hemodynamic changes were examined with an ultrasonic Doppler flowmeter and with a sound-spectrograph in 5 patients with internal carotid giant aneurysms or with recurrent laryngeal cancer undergoing gradual carotid occlusion. The ultrasonic Doppler technique was useful for preoperative assessment of intracranial cross...


    pub_type: 杂志文章


    authors: Moritake K,Handa H,Yonekawa Y,Takebe Y,Kishimoto S,Makimoto K

    更新日期:1981-03-01 00:00:00

  • Quantitative carotid phonoangiography.

    abstract::One hundred and sixteen carotid artery bruits were assessed using quantitative phonoangiography (spectral bruit analysis - SBA). This technique uses the averaged break frequency of the bruit to calculate the diameter of he residual lumen at the site of stenosis. Biplanar contrast arteriography was performed on 43 (37%...


    pub_type: 杂志文章


    authors: Knox R,Breslau P,Strandness DE Jr

    更新日期:1981-11-01 00:00:00

  • Vessel Wall Enhancement and Blood-Cerebrospinal Fluid Barrier Disruption After Mechanical Thrombectomy in Acute Ischemic Stroke.

    abstract:BACKGROUND AND PURPOSE:Less than half of acute ischemic stroke patients treated with mechanical thrombectomy obtain permanent clinical benefits. Consequently, there is an urgent need to identify mechanisms implicated in the limited efficacy of early reperfusion. We evaluated the predictors and prognostic significance o...


    pub_type: 杂志文章


    authors: Renú A,Laredo C,Lopez-Rueda A,Llull L,Tudela R,San-Roman L,Urra X,Blasco J,Macho J,Oleaga L,Chamorro A,Amaro S

    更新日期:2017-03-01 00:00:00