Brain Arteriovenous Malformation Recurrence After Apparent Microsurgical Cure: Increased Risk in Children Who Present With Arteriovenous Malformation Rupture.

Adolescent Angiography, Digital Subtraction Arteriovenous Fistula / diagnostic imaging Brain / diagnostic imaging Child Child, Preschool Female Humans Intracranial Arteriovenous Malformations / diagnostic imaging Male Microsurgery Neurosurgical Procedures Recurrence Retrospective Studies Rupture / surgery Treatment Outcome Young Adult
angiography arteriovenous malformation brain intracranial hemorrhages pediatrics

Journal

Stroke
ISSN: 1524-4628
Titre abrégé: Stroke
Pays: United States
ID NLM: 0235266

Informations de publication

Date de publication:
10 2020
Historique:
pubmed: 12 9 2020
medline: 11 11 2020
entrez: 11 9 2020
Statut: ppublish

Résumé

Do children have an increased risk for brain arteriovenous malformation (AVM) recurrence compared with adults and does this risk vary depending on initial presentation with AVM rupture? We retrospectively studied 115 patients initially presenting with brain AVM under age 25 years who underwent complete surgical resection of the AVM as documented by digital subtraction angiography (DSA) and had delayed follow-up DSA to evaluate for AVM recurrence after apparent initial cure. The mean time from baseline DSA to follow-up DSA was 2.3 years, ranging from 0 to 15 years. Twelve patients (10.4% of the 115 patient cohort and 16.7% of 72 patients with hemorrhage at initial presentation) demonstrated AVM recurrence on follow-up DSA. All patients with recurrence initially presented with intracranial hemorrhage, and intracranial hemorrhage was a significant predictor of recurrence (log rank There is a high rate of recurrence of apparently cured brain AVMs in children who initially present with AVM rupture. Imaging follow-up is warranted to prevent re-rupture.

Sections du résumé

BACKGROUND AND PURPOSE
Do children have an increased risk for brain arteriovenous malformation (AVM) recurrence compared with adults and does this risk vary depending on initial presentation with AVM rupture?
METHODS
We retrospectively studied 115 patients initially presenting with brain AVM under age 25 years who underwent complete surgical resection of the AVM as documented by digital subtraction angiography (DSA) and had delayed follow-up DSA to evaluate for AVM recurrence after apparent initial cure.
RESULTS
The mean time from baseline DSA to follow-up DSA was 2.3 years, ranging from 0 to 15 years. Twelve patients (10.4% of the 115 patient cohort and 16.7% of 72 patients with hemorrhage at initial presentation) demonstrated AVM recurrence on follow-up DSA. All patients with recurrence initially presented with intracranial hemorrhage, and intracranial hemorrhage was a significant predictor of recurrence (log rank
CONCLUSIONS
There is a high rate of recurrence of apparently cured brain AVMs in children who initially present with AVM rupture. Imaging follow-up is warranted to prevent re-rupture.

Identifiants

DOI: 10.1161/STROKEAHA.120.030135 PMID: 32912090 PMC: PMC7731776
pubmed: 32912090
doi: 10.1161/STROKEAHA.120.030135
pmc: PMC7731776
mid: NIHMS1621847
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

2990-2996

Subventions

Organisme : NIBIB NIH HHS
ID : R01 EB012031
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS034949
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS099268
Pays : United States
Organisme : NINDS NIH HHS
ID : U54 NS065705
Pays : United States

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Auteurs

Alexander Copelan (A)

Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging (A.C., G.D., M.T.C., E.R.S., D.L.C., M.R.A., C.F.D., V.V.H., R.T.H., S.W.H.), University of California, San Francisco.

Gerald Drocton (G)

Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging (A.C., G.D., M.T.C., E.R.S., D.L.C., M.R.A., C.F.D., V.V.H., R.T.H., S.W.H.), University of California, San Francisco.

M Travis Caton (MT)

Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging (A.C., G.D., M.T.C., E.R.S., D.L.C., M.R.A., C.F.D., V.V.H., R.T.H., S.W.H.), University of California, San Francisco.

Eric R Smith (ER)

Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging (A.C., G.D., M.T.C., E.R.S., D.L.C., M.R.A., C.F.D., V.V.H., R.T.H., S.W.H.), University of California, San Francisco.

Daniel L Cooke (DL)

Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging (A.C., G.D., M.T.C., E.R.S., D.L.C., M.R.A., C.F.D., V.V.H., R.T.H., S.W.H.), University of California, San Francisco.
Center for Cerebrovascular Research (D.L.C., J.N., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.K., H.J.F., N.G., S.W.H.), University of California, San Francisco.
Pediatric Brain Center (D.L.C., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.J.F., S.W.H.), University of California, San Francisco.

Jeffrey Nelson (J)

Center for Cerebrovascular Research (D.L.C., J.N., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.K., H.J.F., N.G., S.W.H.), University of California, San Francisco.

Adib A Abla (AA)

Center for Cerebrovascular Research (D.L.C., J.N., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.K., H.J.F., N.G., S.W.H.), University of California, San Francisco.
Pediatric Brain Center (D.L.C., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.J.F., S.W.H.), University of California, San Francisco.
Division of Cerebrovascular Neurosurgery, Department of Neurological Surgery (A.A.A., C.F.D., V.V.H., R.T.H.), University of California, San Francisco.

Christine Fox (C)

Center for Cerebrovascular Research (D.L.C., J.N., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.K., H.J.F., N.G., S.W.H.), University of California, San Francisco.
Pediatric Brain Center (D.L.C., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.J.F., S.W.H.), University of California, San Francisco.
Departments of Neurology and Pediatrics (C.F., H.J.F.), University of California, San Francisco.

Matthew R Amans (MR)

Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging (A.C., G.D., M.T.C., E.R.S., D.L.C., M.R.A., C.F.D., V.V.H., R.T.H., S.W.H.), University of California, San Francisco.
Center for Cerebrovascular Research (D.L.C., J.N., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.K., H.J.F., N.G., S.W.H.), University of California, San Francisco.
Pediatric Brain Center (D.L.C., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.J.F., S.W.H.), University of California, San Francisco.

Christopher F Dowd (CF)

Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging (A.C., G.D., M.T.C., E.R.S., D.L.C., M.R.A., C.F.D., V.V.H., R.T.H., S.W.H.), University of California, San Francisco.
Center for Cerebrovascular Research (D.L.C., J.N., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.K., H.J.F., N.G., S.W.H.), University of California, San Francisco.
Pediatric Brain Center (D.L.C., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.J.F., S.W.H.), University of California, San Francisco.
Division of Cerebrovascular Neurosurgery, Department of Neurological Surgery (A.A.A., C.F.D., V.V.H., R.T.H.), University of California, San Francisco.
Department of Anesthesia and Perioperative Care (C.F.D., V.V.H., R.T.H., H.K.), University of California, San Francisco.

Van V Halbach (VV)

Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging (A.C., G.D., M.T.C., E.R.S., D.L.C., M.R.A., C.F.D., V.V.H., R.T.H., S.W.H.), University of California, San Francisco.
Center for Cerebrovascular Research (D.L.C., J.N., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.K., H.J.F., N.G., S.W.H.), University of California, San Francisco.
Pediatric Brain Center (D.L.C., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.J.F., S.W.H.), University of California, San Francisco.
Division of Cerebrovascular Neurosurgery, Department of Neurological Surgery (A.A.A., C.F.D., V.V.H., R.T.H.), University of California, San Francisco.
Department of Anesthesia and Perioperative Care (C.F.D., V.V.H., R.T.H., H.K.), University of California, San Francisco.

Randall T Higashida (RT)

Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging (A.C., G.D., M.T.C., E.R.S., D.L.C., M.R.A., C.F.D., V.V.H., R.T.H., S.W.H.), University of California, San Francisco.
Center for Cerebrovascular Research (D.L.C., J.N., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.K., H.J.F., N.G., S.W.H.), University of California, San Francisco.
Pediatric Brain Center (D.L.C., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.J.F., S.W.H.), University of California, San Francisco.
Division of Cerebrovascular Neurosurgery, Department of Neurological Surgery (A.A.A., C.F.D., V.V.H., R.T.H.), University of California, San Francisco.
Department of Anesthesia and Perioperative Care (C.F.D., V.V.H., R.T.H., H.K.), University of California, San Francisco.

Michael T Lawton (MT)

Division of Pediatric Neurosurgery, Department of Neurological Surgery (N.G.), University of California, San Francisco.
Division of Neurovascular Surgery, Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ (M.T.L.).

Helen Kim (H)

Center for Cerebrovascular Research (D.L.C., J.N., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.K., H.J.F., N.G., S.W.H.), University of California, San Francisco.
Department of Anesthesia and Perioperative Care (C.F.D., V.V.H., R.T.H., H.K.), University of California, San Francisco.

Heather J Fullerton (HJ)

Center for Cerebrovascular Research (D.L.C., J.N., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.K., H.J.F., N.G., S.W.H.), University of California, San Francisco.
Pediatric Brain Center (D.L.C., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.J.F., S.W.H.), University of California, San Francisco.
Departments of Neurology and Pediatrics (C.F., H.J.F.), University of California, San Francisco.

Nalin Gupta (N)

Center for Cerebrovascular Research (D.L.C., J.N., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.K., H.J.F., N.G., S.W.H.), University of California, San Francisco.

Steven W Hetts (SW)

Division of Neurointerventional Radiology, Department of Radiology and Biomedical Imaging (A.C., G.D., M.T.C., E.R.S., D.L.C., M.R.A., C.F.D., V.V.H., R.T.H., S.W.H.), University of California, San Francisco.
Center for Cerebrovascular Research (D.L.C., J.N., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.K., H.J.F., N.G., S.W.H.), University of California, San Francisco.
Pediatric Brain Center (D.L.C., A.A.A., C.F., M.R.A., C.F.D., V.V.H., R.T.H., H.J.F., S.W.H.), University of California, San Francisco.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Techniques de diagnostic cardiovasculaire › Angiographie › Angiographie de soustraction digitale › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › États, signes et symptômes pathologiques › États anatomopathologiques › Fistule › Fistule vasculaire › Fistule artérioveineuse › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › Système nerveux › Système nerveux central › Encéphale › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Enfant d'âge préscolaire › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › Malformations et maladies congénitales, héréditaires et néonatales › Malformations › Malformations du système nerveux › Malformations vasculaires du système nerveux central › Malformations artérioveineuses intracrâniennes › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › Techniques d'investigation › Micromanipulation › Microchirurgie › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de neurochirurgie › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Récidive › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › Plaies et blessures › Rupture › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Brain Arteriovenous Malformation Recurrence...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Jeune adulte › Brain Arteriovenous Malformation Recurrence...