Ultra-early neurological deterioration following a brain arteriovenous malformation rupture.

This study aims to explore the impact of ultra-early neurological deterioration (U-END) on the outcome (mortality and poor neurological status) following a brain arteriovenous malformation (BAVM) rupture and identify determinants of U-END. Patients with BAVM ruptures admitted to a single tertiary care center were retrospectively reviewed. U-END was defined as a worsening by two or more points on the Glasgow Coma Scale (GCS). U-END was tested as a potential predictor of in-hospital mortality and poor outcomes. Univariate and multivariate analyses were performed to identify determinants of U-END. Patients with U-END were also matched and compared with BAVM rupture controls presenting with a GCS close or equal to either their initial or their lowest GCS. A total of 248 patients with BAVM ruptures met the inclusion criteria, with 39 (15.7%) patients presenting with U-END. U-END was not associated with and was not an independent predictor of in-hospital mortality (12.8 vs. 10.5% in the rest of the study population; Ultra-early neurological deterioration in ruptured BAVMs did not result in increased mortality or poor outcomes and was most often related to IVH and hydrocephalus.

Informations de copyright

Copyright © 2024 Shotar, Chiaroni, Haffaf, Cortese, Jacquens, Garzelli, Allard, Elhorany, Amouyal, Mathon, Nouet, Premat, Lenck, Sourour, Degos and Clarençon.

Déclaration de conflit d'intérêts

FC reports conflict of interest (unrelated) with Medtronic, Guerbet, Balt Extrusion (payment for readings), and Codman Neurovascular (core lab). N-AS is consultant for Medtronic, Balt Extrusion, and Microvention (unrelated to the study). ES is principal investigator of a randomized controlled trial related to chronic subdural hematoma embolization financed by a PHRC-IR public grant (unrelated). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.