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P.192 Arterial Hemodynamics and the Clinical Presentation of Cerebral Arteriovenous Malformations
Published online by Cambridge University Press: 05 January 2022
Abstract
Background: Arterial Hemodynamics have been implicated in hemorrhage from cerebral arteriovenous malformations (AVMs). The correlation between hemodynamic characteristics and the tendency of AVMs to rupture has been explored in the past, and various theories have been proposed to explain the clinical presentation of AVMs as a hemorrhage vs. seizure. Methods: We monitored feeder artery pressures in 45 patients with AVMS (16 presenting with hemorrhage, 29 without) during super selective angiography and AVM embolization. Results: Mean feeder artery pressure (FP) was found to be 49mm Hg. The mean FP in patients presenting with hemorrhage was somewhat higher than in those without hemorrhage, but the difference was not statistically significant (53.8 mm Hg vs 47.0 mm Hg, p=0.13). Systemic mean pressure was found to correlate with AVM size (r=-0.31, p=0.037). Significant predictors of feeder artery pressure were systemic pressure, AVM size, and the distance of microcatheter from the circle of Willis. Meanwhile, the presence or absence of venous outflow stenosis and the position of the AVM nidus (superficial or deep to the cortical surface) were the most significant predictors of AVM hemorrhage vs seizures. Conclusions: Anatomic factors may be more important than arterial hemodynamic factors in determining the clinical presentation of cerebral AVMs.
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- Poster Presentations
- Information
- Canadian Journal of Neurological Sciences , Volume 48 , Supplement s3: Canadian Neurological Sciences Federation (CNSF) 2021 Congress , November 2021 , pp. S75 - S76
- Copyright
- © The Author(s), 2021. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation