Turjman F, Massoud T F, Sayre J W, Viñuela F, Guglielmi G, Duckwiler G
Endovascular Therapy Service, UCLA Medical Center, USA.
AJNR Am J Neuroradiol. 1995 Feb;16(2):345-50.
To identify the morphological vascular characteristics of cerebral arteriovenous malformations (AVMs) that predict a clinical presentation of epilepsy.
Fifteen angioarchitectural characteristics of brain AVMs were selected for assessment in 100 consecutive patients referred to our institution for endovascular treatment. In this population, 47% of the AVMs were diagnosed as a consequence of epilepsy. The angioarchitectural characteristics and population demographics were statistically analyzed by means of multivariate analysis.
The following six parameters were found to be the most predictive of epilepsy: cortical location of the AVM, feeding by the middle cerebral artery, cortical location of the feeder, absence of aneurysms, presence of varix/varices in the venous drainage, and association of varix and absence of intranidal aneurysms. Three factors were not among the most predictive factors of epilepsy but were significantly associated with the onset of seizures: AVM feeding by the external carotid artery, a temporal cortical location, and a parietal cortical location.
Detailed analysis of the angioarchitecture of intracranial AVMs has helped us identify features that strongly correlate with epilepsy. This may aid in future understanding of the physiopathologic mechanisms in epilepsy associated with AVMs, and in identifying goals of treatment for epileptogenic AVMs.
确定可预测癫痫临床表现的脑动静脉畸形（AVM）的形态学血管特征。
选择脑AVM的15个血管构筑特征，对连续转诊至我院接受血管内治疗的100例患者进行评估。在该人群中，47%的AVM因癫痫而被诊断。通过多变量分析对血管构筑特征和人群统计学数据进行统计分析。
发现以下六个参数对癫痫最具预测性：AVM的皮质位置、大脑中动脉供血、供血动脉的皮质位置、无动脉瘤、静脉引流中存在静脉曲张和静脉曲张与巢内无动脉瘤相关。三个因素虽不是癫痫最具预测性的因素，但与癫痫发作的起始显著相关：颈外动脉供血的AVM、颞叶皮质位置和顶叶皮质位置。
对颅内AVM血管构筑的详细分析有助于我们识别与癫痫密切相关的特征。这可能有助于未来理解与AVM相关的癫痫的病理生理机制，并确定致痫性AVM的治疗目标。
