Although several descriptions of the angioarchitectural features of brain arteriovenous malformations (AVMs) associated with higher hemorrhagic risk have been reported, the prognostic value of the different bleeding patterns still needs to be elucidated.
This study evaluated the influence on clinical appearance and outcome of the parenchymal and non-parenchymal (subarachnoid hemorrhage—SAH—and intraventricular hemorrhage—IVH) bleedings associated with ruptured AVMs.
Clinical records and neuroradiological examinations of 30 patients with hemorrhagic AVMs were reviewed in order to identify their angioarchitectural features and the associated bleeding pattern. These data along with demographic characteristics and treatment modality were dichotomized and their relationship with clinical status at admission and follow-up was tested.
IVH as well as parenchymal hematomas larger than 20 cm3 appeared associated with a severe clinical status at admission, whereas SAH involving basal cisterns was significantly associated with unfavorable outcome.
Age, sex and angioarchitectural features did not show significant association with the severity of the prognosis.
However, none of these bleeding patterns appeared as an independent risk factor of poor outcome at multivariate analysis.
In conclusion, our data emphasized the possibility that non-parenchymal bleeding may worsen the outcome of patients with hemorrhagic AVMs.
Abbreviations:(AVM-ICH) (AVM related ICH), (AVMs) (brain arteriovenous malformations), (CT) (computed tomography), (DSA) (digital subtraction angiography), (PACS) (electronic picture archiving and communication system), (ICH) (intracranial hemorrhage), (IVH) (intraventricular hemorrhage), (mRS) (modified Rankin Scale), (ICP) (intracranial pressure), (ROIs) (regions of interest)
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Published online: November 12, 2012
Accepted: October 23, 2012
Received in revised form: September 27, 2012
Received: July 8, 2012
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.