Incident Hemorrhage Risk of Brain Arteriovenous Malformations Located in the Arterial Borderzones

摘要: Background and Purpose —We sought to assess the relative risk of hemorrhagic presentation brain arteriovenous malformations (AVMs) located in arterial borderzone territories. Methods —The 464 consecutive, prospectively enrolled patients from New York AVM Databank were analyzed. location was coded positive when malformation supplied by branches at least 2 major circle Willis arteries (anterior, middle, and/or posterior cerebral arteries). AVMs fed only 1 pial or any other single artery served as a comparison group. Clinical (diagnostic event) categorized (1) intracranial hemorrhage, proven imaging, (2) seizure, focal neurological deficit, headache, event with no signs hemorrhage on imaging. Results —In 48% (n=222) patients, territories; 52% (n=242) non-borderzone found. Hemorrhage presenting symptom 44% (n=205); 28% (n=132) presented seizures, 11% (n=52) headaches, 7% (n=34) 9% (n=41) AVM-related symptoms. The frequency incident significantly lower (27%, n=61) than (60%, n=144; P <0.001). This difference remained significant multivariate model controlling for age, sex, size, deep venous drainage, presence aneurysms (odds ratio, 0.4; 95% CI, 0.25 0.66). Conclusions —Our findings suggest that is an independent determinant initial presentation.