脑动脉瘤伴动静脉畸形的特征。

Characteristics of arteriovenous malformations associated with cerebral aneurysms.

机构信息

Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

出版信息

World Neurosurg. 2011 Sep-Oct;76(3-4):288-91. doi: 10.1016/j.wneu.2011.03.022.

DOI:10.1016/j.wneu.2011.03.022

PMID:21986426

Abstract

OBJECTIVE

To analyze the characteristics of brain arteriovenous malformations (AVMs) associated with cerebral aneurysms.

METHODS

A total of 302 consecutive, retrospectively reviewed patients from the Beijing Tiantan Hospital were analyzed in this study. The presence of cerebral aneurysm was confirmed by pretherapeutic selective and superselective angiography. Clinical presentation was categorized as intracranial hemorrhage or nonhemorrhagic presentation. Univariate and multivariate statistical models were applied to test the effect of age, sex, AVM size and location, and venous drainage pattern.

RESULTS

Of the 302 patients, 74 (24.5%) had AVMs associated with cerebral aneurysms. AVMs coexisting with aneurysms were significantly associated with hemorrhage at initial presentation (2.27; 95% confidence interval 1.31-3.95; P = 0.003). Infratentorial AVM location was significantly associated with AVMs coexisting with aneurysms (2.31; 95% confidence interval 1.02-5.24; P = 0.040). Deep or superficial venous drainage, female sex, or AVM size were not significantly associated with AVMs coexisting with aneurysms. The regression model showed significant effect was found for initial presentation with hemorrhage (P = 0.003), age (P = 0.003), and infratentorial AVM location (P = 0.040).

CONCLUSIONS

Our findings suggest that AVMs associated with cerebral aneurysms are frequently associated with initial hemorrhage presentation and infratentorial AVM location.

摘要

目的

分析伴发脑动脉瘤的脑动静脉畸形（AVM）的特征。

方法

本研究分析了来自北京天坛医院的 302 例连续回顾性患者。通过术前选择性和超选择性血管造影证实存在脑动脉瘤。临床表现分为颅内出血或非出血表现。应用单变量和多变量统计模型来检验年龄、性别、AVM 大小和位置以及静脉引流方式的影响。

结果

在 302 例患者中，74 例（24.5%）存在伴发脑动脉瘤的 AVM。伴发动脉瘤的 AVM 与首发时出血显著相关（2.27；95%置信区间 1.31-3.95；P = 0.003）。幕下 AVM 位置与伴发动脉瘤显著相关（2.31；95%置信区间 1.02-5.24；P = 0.040）。深或浅静脉引流、女性或 AVM 大小与伴发动脉瘤无显著相关性。回归模型显示首发时出血（P = 0.003）、年龄（P = 0.003）和幕下 AVM 位置（P = 0.040）有显著影响。