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














  • Remote Ischemic Conditioning May Improve Outcomes of Patients With Cerebral Small-Vessel Disease.

    abstract:BACKGROUND AND PURPOSE:We aimed to evaluate the efficacy of remote ischemic conditioning (RIC) in patients with cerebral small-vessel disease. METHODS:Thirty patients with cerebral small-vessel disease-related mild cognitive impairment were enrolled in this prospective, randomized controlled study for 1 year. Besides ...


    pub_type: 杂志文章,随机对照试验


    authors: Wang Y,Meng R,Song H,Liu G,Hua Y,Cui D,Zheng L,Feng W,Liebeskind DS,Fisher M,Ji X

    更新日期:2017-11-01 00:00:00

  • Assessment of thrombus in acute middle cerebral artery occlusion using thin-slice nonenhanced Computed Tomography reconstructions.

    abstract:BACKGROUND AND PURPOSE:We sought to evaluate how accurately length and volume of thrombotic clots occluding cerebral arteries of patients with acute ischemic stroke can be assessed from nonenhanced CT (NECT) scans reconstructed with different slice widths. METHODS:NECT image data of 58 patients with acute ischemic str...


    pub_type: 杂志文章


    authors: Riedel CH,Jensen U,Rohr A,Tietke M,Alfke K,Ulmer S,Jansen O

    更新日期:2010-08-01 00:00:00

  • Risk of stroke from new carotid artery occlusion in the Asymptomatic Carotid Surgery Trial-1.

    abstract:BACKGROUND AND PURPOSE:In the Asymptomatic Carotid Surgery Trial-1 (ACST-1), 3120 patients with tight asymptomatic carotid stenosis were randomly assigned to medical treatment alone or to carotid endarterectomy and appropriate medication. Successful carotid endarterectomy significantly reduced 10-year stroke risk in yo...


    pub_type: 杂志文章,随机对照试验


    authors: den Hartog AG,Halliday AW,Hayter E,Pan H,Kong X,Moll FL,de Borst GJ,Asymptomatic Carotid Surgery Trial Collaborators.

    更新日期:2013-06-01 00:00:00

  • Mechanism of in-hospital cerebral ischemia.

    abstract::Of 171 patients evaluated prospectively and consecutively for cerebral ischemia, 26 (15%) developed symptoms while hospitalized. Cerebral ischemia complicated operative procedures in 12 patients, unsuccessful cardioversion in one and coronary angiography in another. Twelve patients had apparent cerebral embolism and 1...


    pub_type: 杂志文章


    authors: Kelley RE,Kovacs AG

    更新日期:1986-05-01 00:00:00

  • Iron Overload Exacerbates the Risk of Hemorrhagic Transformation After tPA (Tissue-Type Plasminogen Activator) Administration in Thromboembolic Stroke Mice.

    abstract::Background and Purpose- Recanalization with tPA (tissue-type plasminogen activator) is the only pharmacological therapy available for patients with ischemic stroke. However, the percentage of patients who may receive this therapy is limited by the risk of hemorrhagic transformation (HT)-the main complication of ischem...


    pub_type: 杂志文章


    authors: García-Yébenes I,García-Culebras A,Peña-Martínez C,Fernández-López D,Díaz-Guzmán J,Negredo P,Avendaño C,Castellanos M,Gasull T,Dávalos A,Moro MA,Lizasoain I

    更新日期:2018-09-01 00:00:00

  • Enlargement of spontaneous intracerebral hemorrhage. Incidence and time course.

    abstract:BACKGROUND AND PURPOSE:Standard radiographic criteria for hematoma enlargement have not been established. We undertook this investigation to assess the incidence and time course of hematoma growth using objective cutoff values. METHODS:We reviewed the clinical records of 204 patients with spontaneous intracerebral hem...


    pub_type: 杂志文章


    authors: Kazui S,Naritomi H,Yamamoto H,Sawada T,Yamaguchi T

    更新日期:1996-10-01 00:00:00

  • Silencing of Long Noncoding RNA Nespas Aggravates Microglial Cell Death and Neuroinflammation in Ischemic Stroke.

    abstract::Background and Purpose- Ischemic stroke is one of the leading causes of morbidity and mortality worldwide and a major cause of long-term disability. Recently, long noncoding RNAs have been revealed, which are tightly associated with several human diseases. However, the functions of long noncoding RNAs in ischemic stro...


    pub_type: 杂志文章


    authors: Deng Y,Chen D,Wang L,Gao F,Jin B,Lv H,Zhang G,Sun X,Liu L,Mo D,Ma N,Song L,Huo X,Yan T,Miao Z

    更新日期:2019-07-01 00:00:00

  • Intraventricular Hemorrhage Clearance in Human Neonatal Cerebrospinal Fluid: Associations With Hydrocephalus.

    abstract::Background and Purpose- Preterm neonates with intraventricular hemorrhage (IVH) are at risk for posthemorrhagic hydrocephalus and poor neurological outcomes. Iron has been implicated in ventriculomegaly, hippocampal injury, and poor outcomes following IVH. We hypothesized that levels of cerebrospinal fluid blood break...


    pub_type: 临床试验,杂志文章


    authors: Mahaney KB,Buddhala C,Paturu M,Morales D,Limbrick DD Jr,Strahle JM

    更新日期:2020-06-01 00:00:00

  • Smartphone-assisted prehospital medical information system for analyzing data on prehospital stroke care.

    abstract:BACKGROUND AND PURPOSE:Optimizing prehospital stroke care is important because effective treatments for acute stroke require a narrow therapeutic time window. We developed a smartphone-assisted prehospital medical information system (SPMIS) to facilitate research on prehospital stroke care. METHODS:Prehospital medical...


    pub_type: 杂志文章


    authors: Nakae T,Kataoka H,Kuwata S,Iihara K

    更新日期:2014-05-01 00:00:00

  • α7 nicotinic acetylcholine receptor agonism confers neuroprotection through GSK-3β inhibition in a mouse model of intracerebral hemorrhage.

    abstract:BACKGROUND AND PURPOSE:Perihematomal edema formation and consequent cell death contribute to the delayed brain injury evoked by intracerebral hemorrhage (ICH). We aimed to evaluate the effect of α7 nicotinic acetylcholine receptor (α7nAChR) stimulation on behavior, brain edema, and neuronal apoptosis. Furthermore, we a...


    pub_type: 杂志文章


    authors: Krafft PR,Altay O,Rolland WB,Duris K,Lekic T,Tang J,Zhang JH

    更新日期:2012-03-01 00:00:00

  • Incidental magnetic resonance diffusion-weighted imaging-positive lesions are rare in neurologically asymptomatic community-dwelling adults.

    abstract:BACKGROUND AND PURPOSE:Incidental magnetic resonance diffusion-weighted imaging (DWI)-positive lesions, considered to represent small acute infarcts, have been detected in patients with cerebral small vessel diseases or cognitive impairment, but the prevalence in the community population is unknown. METHODS:DWI sequen...


    pub_type: 杂志文章


    authors: Batool S,O'Donnell M,Sharma M,Islam S,Dagenais GR,Poirier P,Lear SA,Wielgosz A,Teo K,Stotts G,McCreary CR,Frayne R,DeJesus J,Rangarajan S,Yusuf S,Smith EE,PURE Study Investigators.

    更新日期:2014-07-01 00:00:00

  • Different linkage of depression to hypercortisolism early versus late after stroke. A 3-year longitudinal study.

    abstract:BACKGROUND AND PURPOSE:Using the dexamethasone suppression test, we studied the suppressibility of the cortisol axis and its clinical determinants at various time points after stroke. A major aim was to examine the dexamethasone test as a diagnostic tool for the diagnosis of major depression in stroke patients. METHOD...


    pub_type: 杂志文章


    authors: Aström M,Olsson T,Asplund K

    更新日期:1993-01-01 00:00:00

  • Selective brain cooling during and after prolonged global ischemia reduces cortical damage in rats.

    abstract:BACKGROUND AND PURPOSE:Studies of the cerebroprotective effects of selective brain cooling have failed to show amelioration of ischemic injury in the cerebral cortex. This study was designed to test the hypothesis that mild-to-moderate selective brain cooling initiated after the onset of global brain ischemia in rats p...


    pub_type: 杂志文章


    authors: Kuluz JW,Gregory GA,Yu AC,Chang Y

    更新日期:1992-12-01 00:00:00

  • Is white matter involved in patients entered into typical trials of neuroprotection?

    abstract:BACKGROUND AND PURPOSE:One of the reasons for the failure of trials of neuroprotection in stroke may be the lack of white matter (WM) protection. However, whether patients entered into typical neuroprotection trials have WM involved in the ischemic process is unknown. We studied patients who were enrolled in neuroprote...


    pub_type: 杂志文章


    authors: Ho PW,Reutens DC,Phan TG,Wright PM,Markus R,Indra I,Young D,Donnan GA

    更新日期:2005-12-01 00:00:00

  • Proportions of stroke subtypes among men and women > or =40 years of age in an urban Japanese city in 1992, 1997, and 2002.

    abstract:BACKGROUND AND PURPOSE:Higher proportions of hemorrhagic stroke and lacunar infarction were reported in rural Japan compared with those in Western countries. We examined the relative proportions of stroke subtypes in an urban Japanese city where westernized lifestyles are more common than in rural areas. METHODS:Strok...


    pub_type: 杂志文章


    authors: Kitamura A,Nakagawa Y,Sato M,Iso H,Sato S,Imano H,Kiyama M,Okada T,Okada H,Iida M,Shimamoto T

    更新日期:2006-06-01 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

  • A new method for quantitative regional cerebral blood volume measurements using computed tomography.

    abstract:BACKGROUND AND PURPOSE:Knowledge of cerebral blood volume (CBV) is invaluable in identifying the primary cause of brain swelling in patients with stroke or severe head injury, and it might also help in clinical decision making in patients thought to have hemodynamic transient ischemic attacks (TIAs). This investigation...


    pub_type: 杂志文章


    authors: Muizelaar JP,Fatouros PP,Schröder ML

    更新日期:1997-10-01 00:00:00

  • Thrombosis in a congenitally bifurcated superior sagittal sinus.

    abstract::A 26-year-old woman had a peripartum venous thrombotic stroke involving the right parietal lobe. The initial thrombus was present only in the right channel of a congenitally bifurcated superior sagittal sinus. This diagnosis and subsequent thrombus extension were readily shown by magnetic resonance imaging in contrast...


    pub_type: 杂志文章


    authors: Hosley MA,Fisher M,Lingley JF

    更新日期:1991-03-01 00:00:00

  • Reliability of prehospital real-time cellular video phone in assessing the simplified National Institutes Of Health Stroke Scale in patients with acute stroke: a novel telemedicine technology.

    abstract:BACKGROUND AND PURPOSE:The National Institutes of Health Stroke Scale (NIHSS) is the gold standard to assess patients with acute stroke. We aimed to examine the feasibility and reliability of prehospital real-time cellular video phone (VP) in performing the NIHSS. METHODS:Forty physicians prospectively performed a sim...


    pub_type: 杂志文章


    authors: Gonzalez MA,Hanna N,Rodrigo ME,Satler LF,Waksman R

    更新日期:2011-06-01 00:00:00

  • Effects of insulin on blood, plasma, and brain glucose in hyperglycemic diabetic rats.

    abstract::This study, in biologically bred hyperglycemic diabetic rats, examined the effect of a intravenous insulin infusion (1.5 units.hr-1) on blood, plasma, and brain glucose concentrations to determine their relationship during decreasing blood and plasma glucose levels. The data were compared to saline-treated diabetic ra...


    pub_type: 杂志文章


    authors: Hofer RE,Lanier WL

    更新日期:1991-04-01 00:00:00

  • The effect of graduated compression stockings on long-term outcomes after stroke: the CLOTS trials 1 and 2.

    abstract:BACKGROUND AND PURPOSE:Most randomized controlled trials of venous thromboembolism prophylaxis have focused on reduction of deep vein thrombosis, predominantly asymptomatic deep vein thrombosis, detected on imaging. We aimed to estimate the effects of graduated compression stockings on venous thromboembolism events, su...


    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: CLOTS Trials Collaboration.,Dennis M,Sandercock P,Reid J,Graham C,Murray G,Venables G,Rudd A,Bowler G

    更新日期:2013-04-01 00:00:00

  • Risk factors, clinical presentation, and neuroimaging findings of neonatal perforator stroke.

    abstract:BACKGROUND AND PURPOSE:To date, studies on neonatal stroke have mainly focused on cortical stroke. We have focused on perforator strokes, noncortical strokes in the arterial vascular perforator area. We sought to identify risk factors and evaluate clinical presentation and neuroimaging findings for neonatal perforator ...


    pub_type: 杂志文章


    authors: Ecury-Goossen GM,Raets MM,Lequin M,Feijen-Roon M,Govaert P,Dudink J

    更新日期:2013-08-01 00:00:00

  • Mild hypothermia after intravenous thrombolysis in patients with acute stroke: a randomized controlled trial.

    abstract:BACKGROUND AND PURPOSE:Hypothermia improves outcome in resuscitated patients and newborns with hypoxic brain injury. We studied the safety and feasibility of mild hypothermia in awake patients with stroke after intravenous thrombolysis. METHODS:Patients were randomized 1:1 to mild hypothermia (35°C) or to standard str...


    pub_type: 杂志文章,随机对照试验


    authors: Piironen K,Tiainen M,Mustanoja S,Kaukonen KM,Meretoja A,Tatlisumak T,Kaste M

    更新日期:2014-02-01 00:00:00

  • Arterial Wall Imaging in Pediatric Stroke.

    abstract:BACKGROUND AND PURPOSE:Arteriopathy is common in childhood arterial ischemic stroke (AIS) and predicts stroke recurrence. Currently available vascular imaging techniques mainly image the arterial lumen rather than the vessel wall and have a limited ability to differentiate among common arteriopathies. We aimed to inves...


    pub_type: 杂志文章


    authors: Dlamini N,Yau I,Muthusami P,Mikulis DJ,Elbers J,Slim M,Askalan R,MacGregor D,deVeber G,Shroff M,Moharir M

    更新日期:2018-04-01 00:00:00

  • Hypertonic saline in patients with poor-grade subarachnoid hemorrhage improves cerebral blood flow, brain tissue oxygen, and pH.

    abstract:BACKGROUND AND PURPOSE:Delayed cerebral ischemia and infarction due to reduced CBF remains the leading cause of poor outcome after aneurysmal subarachnoid hemorrhage. Hypertonic saline (HS) is associated with an increase in CBF. This study explores whether CBF enhancement with HS in patients with poor-grade subarachnoi...


    pub_type: 杂志文章


    authors: Al-Rawi PG,Tseng MY,Richards HK,Nortje J,Timofeev I,Matta BF,Hutchinson PJ,Kirkpatrick PJ

    更新日期:2010-01-01 00:00:00

  • Vasodilator proteins: role in delayed cerebral vasospasm.

    abstract::Blood proteins could play a critical role in the pathogenesis of cerebral vasospasm in subarachnoid hemorrhage (SAH) as agonists and as antagonists of vasoconstriction. The present study was designed primarily to quantify the inhibition produced by antithrombin III of the phasic responses elicited by cumulative doses ...


    pub_type: 杂志文章


    authors: White RP

    更新日期:1986-03-01 00:00:00

  • Stroke symptoms in individuals reporting no prior stroke or transient ischemic attack are associated with a decrease in indices of mental and physical functioning.

    abstract:BACKGROUND AND PURPOSE:Stroke symptoms in the absence of recognized stroke are common, but potential associated dysfunctions have not been described. METHODS:We assessed quality-of-life measures using the Physical and Mental Component Summary scores of the Short Form 12 (PCS-12 and MCS-12) in the REasons for Geographi...


    pub_type: 杂志文章


    authors: Howard G,Safford MM,Meschia JF,Moy CS,Howard VJ,Pulley L,Gomez CR,Crowther M

    更新日期:2007-09-01 00:00:00

  • Race and gender differences in 1-year outcomes for community-dwelling stroke survivors with family caregivers.

    abstract:BACKGROUND AND PURPOSE:Previous research has reported worse outcomes after stroke for women and for African Americans, but few prospective population-based studies have systematically examined demographic differences on long-term stroke outcomes. Race and gender differences in 1-year stroke outcomes were examined using...


    pub_type: 杂志文章


    authors: Roth DL,Haley WE,Clay OJ,Perkins M,Grant JS,Rhodes JD,Wadley VG,Kissela B,Howard G

    更新日期:2011-03-01 00:00:00

  • Longitudinal study of motor recovery after stroke: recruitment and focusing of brain activation.

    abstract:BACKGROUND AND PURPOSE:The goal of this study was to characterize cortical reorganization after stroke and its relation with the site of the stroke-induced lesion and degree of motor recovery using functional MRI (fMRI). METHODS:Fourteen stroke patients with an affected upper limb were studied longitudinally. Three fM...


    pub_type: 杂志文章


    authors: Feydy A,Carlier R,Roby-Brami A,Bussel B,Cazalis F,Pierot L,Burnod Y,Maier MA

    更新日期:2002-06-01 00:00:00

  • Postischemic production of eicosanoids in gerbil brain.

    abstract::The postischemic production of PGE2, PGD2, 6-keto-PGF1 alpha, and TXB2 in brain tissue was studied in Mongolian gerbils using tissue extraction as well as a new ex vivo method. This new method permits the study of prostaglandin synthesis in slices from discrete areas of the brain (cortex, hippocampus, striatum, hypoth...


    pub_type: 杂志文章


    authors: Kempski O,Shohami E,von Lubitz D,Hallenbeck JM,Feuerstein G

    更新日期:1987-01-01 00:00:00