Department of Neurosurgery, Hospital Nacional Daniel Alcides Carrión, Callao, Peru.
School of Medicine, National University of San Marcos, Lima, Peru.
Acta Neurochir (Wien). 2024 May 13;166(1):211. doi: 10.1007/s00701-024-06105-y.
The location of brain arteriovenous malformations (bAVM) is one of the most relevant prognostic factors included in surgical, endovascular and radiosurgical scores. However, their characteristics according to location are seldom described. The goal of this study was to describe the clinical and angiographic characteristics of bAVM classified according to their location.
This retrospective observational study included patients diagnosed with bAVM and attending a national referral hospital during the period 2010-2020. Data regarding clinical and angiographic variables were extracted, including characteristics on nidus, arterial afferents, venous drainage and associated aneurysms. BAVM were classified in 8 groups according to their location: frontal, temporal, parieto-occipital, periventricular, deep, cerebellar, brainstem and mixed. Data distribution for each group was determined and between-group differences were assessed.
A total of 269 bAVM (in 258 patients) were included. The most frequent location was parieto-occipital; and the least frequent, brainstem. Statistically significant differences were observed between groups for most studied variables, including: clinical presentation, functional status at admission; nidus size and density, classification according to the Spetzler-Martin, Buffalo and modified Pollock-Flickinger scales; number, diameter, origin and type of afferents; number, diameter, type and direction of venous drainage, retrograde venous flow; and presence and size of flow-related aneurysms.
The clinical and angiographic differences observed between brain AVM groups allow the formulation of profiles according to their location.
脑动静脉畸形（bAVM）的位置是手术、血管内和放射外科评分中包含的最重要的预后因素之一。然而，根据位置描述其特征的情况很少。本研究的目的是根据位置描述 bAVM 的临床和血管造影特征。
这是一项回顾性观察研究，纳入了 2010 年至 2020 年期间在一家国家转诊医院就诊的 bAVM 患者。提取了与临床和血管造影变量相关的数据，包括病灶、动脉供血、静脉引流和相关动脉瘤的特征。根据位置将 bAVM 分为 8 组：额、颞、顶枕、脑室周围、深部、小脑、脑干和混合。确定了每组的数据分布，并评估了组间差异。
共纳入 269 例 bAVM（258 例患者）。最常见的位置是顶枕部，最不常见的是脑干。对于大多数研究变量，组间观察到具有统计学意义的差异，包括：临床表现、入院时的功能状态；病灶大小和密度、根据 Spetzler-Martin、Buffalo 和改良 Pollock-Flickinger 分级的分类；供血动脉的数量、直径、起源和类型；引流静脉的数量、直径、类型和方向、逆行静脉血流；以及与血流相关的动脉瘤的存在和大小。
根据位置观察到的脑 AVM 组之间的临床和血管造影差异，可以制定出根据其位置的特征描述。
