Influence of patient age on angioarchitecture of brain arteriovenous malformations.
Influence of patient age on angioarchitecture of brain arteriovenous malformations.
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DOI：
10.3174/ajnr.a3886
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发表时间：
2014-07
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影响因子：
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通讯作者：
Kim H
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文献类型：
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作者：
Hetts SW;Cooke DL;Nelson J;Gupta N;Fullerton H;Amans MR;Narvid JA;Moftakhar P;McSwain H;Dowd CF;Higashida RT;Halbach VV;Lawton MT;Kim H
确定儿童和成人脑AVM的临床和血管结构特征是否不同。查询了自2001年以来前瞻性收集的所有诊断为脑AVM患者的机构数据库。总结了人口统计学、临床和血管结构信息，并采用单变量和多变量模型进行分析。当将年龄作为连续变量处理时，结果通常不同，而不是将受试者分为儿童（≤18岁; n=203）与成人（>18岁; n=630）。儿童比成人更容易出现AVM出血（59% vs. 41%，p<0.001）。尽管具有较大病灶的AVM出现在较年轻的年龄（>6 cm的平均年龄为26.8岁，而<3 cm的平均年龄为37.1岁），但儿童和成人之间没有显著差异（p=0.069）。单纯深静脉引流在年轻受试者中更常见，无论是连续治疗（p=0.04）还是二分治疗（p<0.001）。静脉扩张随着年龄的增长而更常见（平均39.4岁有扩张，31.1岁无扩张），当成人与儿童相比时（52%比35%，p<0.001）。患有供血动脉动脉瘤的患者平均年龄（44.1岁）比没有此类动脉瘤的患者（31.6岁）晚;当将儿童与成人进行比较时，这一观察结果仍然存在（13% vs. 29%，p<0.001）。虽然患有脑AVM的儿童比成人更容易因出血而引起临床关注，但静脉扩张和供血动脉瘤在儿童中的代表性不足，表明这些特定的高风险特征需要时间才能形成。
To determine if clinical and angioarchitectural features of brain AVMs differ between children and adults. A prospectively collected institutional database 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 often differed when age was treated as a continuous variable as opposed to dividing subjects into children (≤18 years; n=203) versus adults (>18 years; n=630). Children were more likely to present with AVM hemorrhage than adults (59% vs. 41%, p<0.001). Although AVMs with a larger nidus presented at younger ages (mean of 26.8 years for >6 cm compared to 37.1 years for <3 cm), this was not significantly different between children and adults (p=0.069). Exclusively deep venous drainage was more common in younger subjects both when age was treated continuously (p=0.04), or dichotomized (p<0.001). Venous ectasia was more common with increasing age (mean, 39.4 years with ectasia compared to 31.1 years without ectasia) and when adults were compared to children (52% vs. 35%, p<0.001). Patients with feeding artery aneurysms presented at later average age (44.1 years) than those without such aneurysms (31.6 years); this observation persisted when comparing children to adults (13% vs. 29%, p<0.001). 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 underrepresented in children, suggesting that these particular high risk features take time to develop.