MR characteristics of unruptured intracranial arteriovenous malformations associated with seizure as initial clinical presentation.
Adolescent
Adult
Arteriovenous Fistula
/ complications
Female
Frontal Lobe
/ diagnostic imaging
Humans
Intracranial Arteriovenous Malformations
/ complications
Magnetic Resonance Imaging
/ methods
Male
Middle Aged
Radiosurgery
/ methods
Retrospective Studies
Seizures
/ diagnostic imaging
Single-Blind Method
Temporal Lobe
/ diagnostic imaging
Young Adult
arteriovenous malformation
Journal
Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
14
04
2019
revised:
23
06
2019
accepted:
24
06
2019
pubmed:
20
7
2019
medline:
22
7
2020
entrez:
20
7
2019
Statut:
ppublish
Résumé
Patients with intracranial arteriovenous malformations (AVMs) are at increased risk of seizures. To identify MRI characteristics of unruptured intracranial AVMs associated with seizures at presentation. A retrospective review was completed of patients diagnosed with unruptured intracranial AVMs on MRI between January 1, 2000 and December 31, 2016. Two blinded reviewers assessed demographics, lesion locality, and imaging and architectural characteristics of AVMs and surrounding parenchyma, including, but not limited to, AVM location, venous drainage pattern, venous varix, thrombosed venous varix, long draining vein, AVM-related gliosis, peri-AVM edema, and peri-AVM T2* signal. Findings were statistically analyzed for correlation with seizure using Student's t-test for continuous variables and Χ Of 165 included patients, 57/165 (34.5%) patients were imaged as part of an investigation for seizures. Patients with seizures more commonly had peri-AVM edema (36.8%, compared with 11.1% of non-seizure patients, p<0.0001), peri-AVM T2* blooming (28.1% vs 7.4%; p=0.029), a venous pouch/varix (61.4% vs 31.5%, p=0.0003), long draining vein (91.2% vs 55.6%, p<0.0001), and larger size based on Spetzler-Martin grade categorization (p=0.006). By location, AVMs located in the frontal lobe, primary motor cortex, and primary sensory cortex were associated with seizures (p=0.004, p=0.001, and p=0.006, respectively); temporal lobe location was not associated with seizures (p=0.459). Certain MRI characteristics of unruptured intracranial AVMs are associated with seizures. Such correlations may assist in identifying the pathophysiological mechanisms by which AVMs cause seizures.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with intracranial arteriovenous malformations (AVMs) are at increased risk of seizures.
OBJECTIVE
OBJECTIVE
To identify MRI characteristics of unruptured intracranial AVMs associated with seizures at presentation.
MATERIALS AND METHODS
METHODS
A retrospective review was completed of patients diagnosed with unruptured intracranial AVMs on MRI between January 1, 2000 and December 31, 2016. Two blinded reviewers assessed demographics, lesion locality, and imaging and architectural characteristics of AVMs and surrounding parenchyma, including, but not limited to, AVM location, venous drainage pattern, venous varix, thrombosed venous varix, long draining vein, AVM-related gliosis, peri-AVM edema, and peri-AVM T2* signal. Findings were statistically analyzed for correlation with seizure using Student's t-test for continuous variables and Χ
RESULTS
RESULTS
Of 165 included patients, 57/165 (34.5%) patients were imaged as part of an investigation for seizures. Patients with seizures more commonly had peri-AVM edema (36.8%, compared with 11.1% of non-seizure patients, p<0.0001), peri-AVM T2* blooming (28.1% vs 7.4%; p=0.029), a venous pouch/varix (61.4% vs 31.5%, p=0.0003), long draining vein (91.2% vs 55.6%, p<0.0001), and larger size based on Spetzler-Martin grade categorization (p=0.006). By location, AVMs located in the frontal lobe, primary motor cortex, and primary sensory cortex were associated with seizures (p=0.004, p=0.001, and p=0.006, respectively); temporal lobe location was not associated with seizures (p=0.459).
CONCLUSIONS
CONCLUSIONS
Certain MRI characteristics of unruptured intracranial AVMs are associated with seizures. Such correlations may assist in identifying the pathophysiological mechanisms by which AVMs cause seizures.
Identifiants
pubmed: 31320549
pii: neurintsurg-2019-015021
doi: 10.1136/neurintsurg-2019-015021
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
186-191Informations de copyright
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.