Subsequent haemorrhage in children with untreated brain arteriovenous malformation: Higher risk with unbalanced inflow and outflow angioarchitecture.
Eur Radiol
; 27(7): 2868-2876, 2017 Jul.
Article
em En
| MEDLINE
| ID: mdl-27900505
ABSTRACT
OBJECTIVES:
Children with brain arteriovenous malformations (bAVMs) are at risk of life-threatening haemorrhage in their early lives. Our aim was to analyse various angioarchitectural features of bAVM to predict the risk of subsequent haemorrhage during follow-up in children.METHODS:
We identified all consecutive children admitted to our institution for bAVMs between July 2009 and September 2015. Children with at least 1 month of treatment-free follow-up after diagnosis were included in further analysis. Annual rates of AVM rupture as well as several potential risk factors for subsequent haemorrhage were analysed using Kaplan-Meier analyses and Cox proportional hazards regression models.RESULTS:
We identified 110 paediatric patients with a mean follow-up period of 2.1 years (range, 1 month-15.4 years). The average annual risk of haemorrhage from untreated AVMs was 4.3 % in children. No generalised venous ectasia in conjunction with fast arteriovenous shunt was predictive of subsequent haemorrhage (RR, 7.55; 95 % CI 1.96-29.06). The annual rupture risk was 11.1 % in bAVMs without generalised venous ectasia but with fast arteriovenous shunt.CONCLUSIONS:
bAVM angiographic features suggesting unbalanced inflow and outflow might be helpful to identify children at higher risk for future haemorrhage. KEY POINTS ⢠Haemorrhage risk stratification is important for children with untreated brain AVM. ⢠Angiographic features suggesting unbalanced inflow and outflow predict paediatric brain AVM haemorrhage. ⢠Identifying AVMs with high rupture risk help patient selection and tailoring treatment.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Imageamento por Ressonância Magnética
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Angiografia Cerebral
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Malformações Arteriovenosas Intracranianas
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Hemorragia Cerebral
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Circulação Cerebrovascular
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Medição de Risco
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Newborn
País/Região como assunto:
Asia
Idioma:
En
Revista:
Eur Radiol
Ano de publicação:
2017
Tipo de documento:
Article