Factors associated with proximal intracranial aneurysms to brain arteriovenous malformations: A prospective cohort study

Michael Kerin Morgan, Khalid Alsahli, Markus Wiedmann, Nazih N. Assaad, Gillian Z. Heller

Research output: Contribution to journalReview articleResearchpeer-review

Abstract

BACKGROUND: The risk of hemorrhage from a brain arteriovenous malformation (bAVM) is increased when an associated proximal intracranial aneurysm (APIA) is present. Identifying factors that are associated with APIA may influence the prediction of hemorrhage in patients with bAVM. OBJECTIVE: To identify patient- and bAVM-specific factors associated with APIA. METHODS: We analyzed a prospective database of bAVMs for factors associated with the presence of APIA. Factors analyzed included age, sex, bAVM size, aneurysm size, circulation contributing to the bAVM, location of the aneurysm, deep venous drainage, and Spetzler-Ponce categories. Multiple logistic regression was performed to identify an association with APIA. RESULTS: Of 753 cases of bAVM with complete angiographic surveillance, 67 (9%) were found to have APIA. Older age (continuous variable; odds ratio, 1.04; 95% confidence interval, 1.02-1.05) and posterior circulation supply to the bAVM (odds ratio, 2.29; 95% confidence interval, 1.32-3.99) were factors associated with increased detection of APIA. The association of posterior circulation-supplied bAVM was not due to infratentorial bAVM location because 72% of posterior circulation APIAs were supplying supratentorial bAVM. CONCLUSION: APIAs appear to develop with time, as evident from the increased age for those with APIAs. Furthermore, they were more likely present in bAVMs supplied by the posterior circulation. This may be due to a difference in hemodynamic stress.

LanguageEnglish
Pages787-792
Number of pages6
JournalNeurosurgery
Volume78
Issue number6
DOIs
Publication statusPublished - 1 Jun 2016

Fingerprint

Arteriovenous Malformations
Intracranial Aneurysm
Cohort Studies
Prospective Studies
Brain
Aneurysm
Odds Ratio
Confidence Intervals
Intracranial Hemorrhages
Drainage
Logistic Models
Hemodynamics
Databases
Hemorrhage

Keywords

  • Aneurysm
  • AVM
  • Brain
  • Cohort
  • Intracranial

Cite this

Morgan, Michael Kerin ; Alsahli, Khalid ; Wiedmann, Markus ; Assaad, Nazih N. ; Heller, Gillian Z. / Factors associated with proximal intracranial aneurysms to brain arteriovenous malformations : A prospective cohort study. In: Neurosurgery. 2016 ; Vol. 78, No. 6. pp. 787-792.
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abstract = "BACKGROUND: The risk of hemorrhage from a brain arteriovenous malformation (bAVM) is increased when an associated proximal intracranial aneurysm (APIA) is present. Identifying factors that are associated with APIA may influence the prediction of hemorrhage in patients with bAVM. OBJECTIVE: To identify patient- and bAVM-specific factors associated with APIA. METHODS: We analyzed a prospective database of bAVMs for factors associated with the presence of APIA. Factors analyzed included age, sex, bAVM size, aneurysm size, circulation contributing to the bAVM, location of the aneurysm, deep venous drainage, and Spetzler-Ponce categories. Multiple logistic regression was performed to identify an association with APIA. RESULTS: Of 753 cases of bAVM with complete angiographic surveillance, 67 (9{\%}) were found to have APIA. Older age (continuous variable; odds ratio, 1.04; 95{\%} confidence interval, 1.02-1.05) and posterior circulation supply to the bAVM (odds ratio, 2.29; 95{\%} confidence interval, 1.32-3.99) were factors associated with increased detection of APIA. The association of posterior circulation-supplied bAVM was not due to infratentorial bAVM location because 72{\%} of posterior circulation APIAs were supplying supratentorial bAVM. CONCLUSION: APIAs appear to develop with time, as evident from the increased age for those with APIAs. Furthermore, they were more likely present in bAVMs supplied by the posterior circulation. This may be due to a difference in hemodynamic stress.",
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Factors associated with proximal intracranial aneurysms to brain arteriovenous malformations : A prospective cohort study. / Morgan, Michael Kerin; Alsahli, Khalid; Wiedmann, Markus; Assaad, Nazih N.; Heller, Gillian Z.

In: Neurosurgery, Vol. 78, No. 6, 01.06.2016, p. 787-792.

Research output: Contribution to journalReview articleResearchpeer-review

TY - JOUR

T1 - Factors associated with proximal intracranial aneurysms to brain arteriovenous malformations

T2 - Neurosurgery

AU - Morgan, Michael Kerin

AU - Alsahli, Khalid

AU - Wiedmann, Markus

AU - Assaad, Nazih N.

AU - Heller, Gillian Z.

PY - 2016/6/1

Y1 - 2016/6/1

N2 - BACKGROUND: The risk of hemorrhage from a brain arteriovenous malformation (bAVM) is increased when an associated proximal intracranial aneurysm (APIA) is present. Identifying factors that are associated with APIA may influence the prediction of hemorrhage in patients with bAVM. OBJECTIVE: To identify patient- and bAVM-specific factors associated with APIA. METHODS: We analyzed a prospective database of bAVMs for factors associated with the presence of APIA. Factors analyzed included age, sex, bAVM size, aneurysm size, circulation contributing to the bAVM, location of the aneurysm, deep venous drainage, and Spetzler-Ponce categories. Multiple logistic regression was performed to identify an association with APIA. RESULTS: Of 753 cases of bAVM with complete angiographic surveillance, 67 (9%) were found to have APIA. Older age (continuous variable; odds ratio, 1.04; 95% confidence interval, 1.02-1.05) and posterior circulation supply to the bAVM (odds ratio, 2.29; 95% confidence interval, 1.32-3.99) were factors associated with increased detection of APIA. The association of posterior circulation-supplied bAVM was not due to infratentorial bAVM location because 72% of posterior circulation APIAs were supplying supratentorial bAVM. CONCLUSION: APIAs appear to develop with time, as evident from the increased age for those with APIAs. Furthermore, they were more likely present in bAVMs supplied by the posterior circulation. This may be due to a difference in hemodynamic stress.

AB - BACKGROUND: The risk of hemorrhage from a brain arteriovenous malformation (bAVM) is increased when an associated proximal intracranial aneurysm (APIA) is present. Identifying factors that are associated with APIA may influence the prediction of hemorrhage in patients with bAVM. OBJECTIVE: To identify patient- and bAVM-specific factors associated with APIA. METHODS: We analyzed a prospective database of bAVMs for factors associated with the presence of APIA. Factors analyzed included age, sex, bAVM size, aneurysm size, circulation contributing to the bAVM, location of the aneurysm, deep venous drainage, and Spetzler-Ponce categories. Multiple logistic regression was performed to identify an association with APIA. RESULTS: Of 753 cases of bAVM with complete angiographic surveillance, 67 (9%) were found to have APIA. Older age (continuous variable; odds ratio, 1.04; 95% confidence interval, 1.02-1.05) and posterior circulation supply to the bAVM (odds ratio, 2.29; 95% confidence interval, 1.32-3.99) were factors associated with increased detection of APIA. The association of posterior circulation-supplied bAVM was not due to infratentorial bAVM location because 72% of posterior circulation APIAs were supplying supratentorial bAVM. CONCLUSION: APIAs appear to develop with time, as evident from the increased age for those with APIAs. Furthermore, they were more likely present in bAVMs supplied by the posterior circulation. This may be due to a difference in hemodynamic stress.

KW - Aneurysm

KW - AVM

KW - Brain

KW - Cohort

KW - Intracranial

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DO - 10.1227/NEU.0000000000001114

M3 - Review article

VL - 78

SP - 787

EP - 792

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 6

ER -