Persistent hemodynamic changes in ruptured brain arteriovenous malformations.

Abstract:

BACKGROUND AND PURPOSE:Hemodynamic properties of brain arteriovenous malformations (AVMs) with risk factors for a future hemorrhage are essentially unknown. We hypothesized that AVMs with anatomic properties, which are associated with an increased rupture risk, exhibit different hemodynamic characteristics than those without these properties. METHODS:Seventy-two consecutive patients with AVMs diagnosed by conventional angiography underwent MRI examination, including time-resolved 3-dimensional MR angiography. Signal-intensity curves derived from the time-resolved 3-dimensional MR angiography datasets were used to calculate relative blood flow transit times through the AVM nidus based on the time-to-peak parameter. For identification of characteristics associated with altered transit times, a multiple normal regression model was fitted with stepwise selection of the following regressors: intracranial hemorrhage, deep nidus location, infratentorial location, deep drainage, associated aneurysm, nidus size, draining venous stenosis, and number of draining veins. RESULTS:A previous intracranial hemorrhage is the only characteristic that was associated with a significant alteration of the relative transit time, leading to an increase of 2.4 seconds (95% CI, 1.2-3.6 seconds;, P<0.001) without adjustment and 2.1 seconds (95% CI, 0.6-3.6 seconds; P=0.007) with adjustment for all other regressors considered. The association was independent of the bleeding age. CONCLUSIONS:Hemodynamic parameters do not seem useful for risk assessment of an AVM-related hemorrhage because only a previous AVM rupture leads to a significant and permanent alteration of the hemodynamic situation.

journal_name

Stroke

journal_title

Stroke

authors

Illies T,Forkert ND,Saering D,Wenzel K,Ries T,Regelsberger J,Wegscheider K,Fiehler J

doi

10.1161/STROKEAHA.112.669945

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

2910-5

issue

11

eissn

0039-2499

issn

1524-4628

pii

43/11/2910

journal_volume

43

pub_type

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