Influence of patient age on angioarchitecture of brain arteriovenous malformations

Authors

Steven W. Hetts, University of California, San Francisco
D. L. Cooke, University of California, San Francisco
J. Nelson, University of California, San Francisco
N. Gupta, University of California, San Francisco
H. Fullerton, University of California, San Francisco
M. R. Amans, University of California, San Francisco
J. A. Narvid, University of California, San Francisco
P. Moftakhar, University of California, San Francisco
H. McSwain, University of California, San Francisco
C. F. Dowd, University of California, San Francisco
R. T. Higashida, University of California, San Francisco
V. V. Halbach, University of California, San Francisco
M. T. Lawton, University of California, San FranciscoFollow
H. Kim, University of California, San Francisco

Document Type

Article

Abstract

BACKGROUND AND PURPOSE: The imaging characteristics and modes of presentation of brain AVMs may vary with patient age. Our aim was to determine whether clinical and angioarchitectural features of brain AVMs differ between children and adults. MATERIALS AND METHODS: A prospectively collected institutional data base of all patients diagnosed with brain AVMs since 2001 was queried. Demographic, clinical, and angioarchitecture information was summarized and analyzed with univariable and multivariable models. RESULTS: Results often differed when age was treated as a continuous variable as opposed to dividing subjects into children (18 years or younger; n = 203) versus adults (older than 18 years; n = 630). Children were more likely to present with AVM hemorrhage than adults (59% versus 41%, P < .001). Although AVMs with a larger nidus presented at younger ages (mean of 26.8 years for >6 cm compared with 37.1 years for <3 cm), this feature was not significantly different between children and adults (P = .069). Exclusively deep venous drainage was more common in younger subjects when age was treated continuously (P = .04) or dichotomized (P < .001). Venous ectasia was more common with increasing age (mean, 39.4 years with ectasia compared with 31.1 years without ectasia) and when adults were compared with children (52% versus 35%, P < .001). Patients with feeding artery aneurysms presented at a later average age (44.1 years) than those without such aneurysms (31.6 years); this observation persisted when comparing children with adults (13% versus 29%, P < .001). CONCLUSIONS: Although children with brain AVMs were more likely to come to clinical attention due to hemorrhage than adults, venous ectasia and feeding artery aneurysms were under-represented in children, suggesting that these particular high-risk features take time to develop.

Publication Date

1-1-2014

Publication Title

American Journal of Neuroradiology

ISSN

01956108

E-ISSN

1936959X

Volume

35

Issue

7

First Page

1376

Last Page

1380

PubMed ID

24627452

Digital Object Identifier (DOI)

10.3174/ajnr.A3886

Recommended Citation

Hetts, Steven W.; Cooke, D. L.; Nelson, J.; Gupta, N.; Fullerton, H.; Amans, M. R.; Narvid, J. A.; Moftakhar, P.; McSwain, H.; Dowd, C. F.; Higashida, R. T.; Halbach, V. V.; Lawton, M. T.; and Kim, H., "Influence of patient age on angioarchitecture of brain arteriovenous malformations" (2014). Neurosurgery. 1071.
https://scholar.barrowneuro.org/neurosurgery/1071