The rs9509 polymorphism of MMP-9 is associated with risk of hemorrhage in brain arteriovenous malformations

2012 ◽  
Vol 19 (9) ◽  
pp. 1287-1290 ◽  
Author(s):  
Bing Sun ◽  
Huijia Qiu ◽  
Fan Zhao ◽  
Nidan Qiao ◽  
Weiwei Fan ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Brain Arteriovenous Malformations ◽  
Risk Of Hemorrhage

Brain arteriovenous malformations

Neurology ◽  
2020 ◽  
Vol 95 (20) ◽  
pp. 917-927 ◽  
Author(s):  
Ching-Jen Chen ◽  
Dale Ding ◽  
Colin P. Derdeyn ◽  
Giuseppe Lanzino ◽  
Robert M. Friedlander ◽  
...  
Keyword(s):  
Natural History ◽  
Minimally Invasive ◽  
Arteriovenous Malformations ◽  
Cerebral Arteries ◽  
Treatment Strategies ◽  
Latency Period ◽  
Management Options ◽  
Brain Arteriovenous Malformations ◽  
Risk Of Hemorrhage ◽  
Brain Avms

Brain arteriovenous malformations (AVMs) are anomalous direct shunts between cerebral arteries and veins that convalesce into a vascular nidus. The treatment strategies for AVMs are challenging and variable. Intracranial hemorrhage and seizures comprise the most common presentations of AVMs. However, incidental AVMs are being diagnosed with increasing frequency due to widespread use of noninvasive neuroimaging. The balance between the estimated cumulative lifetime hemorrhage risk vs the risk of intervention is often the major determinant for treatment. Current management options include surgical resection, embolization, stereotactic radiosurgery (SRS), and observation. Complete nidal obliteration is the goal of AVM intervention. The risks and benefits of interventions vary and can be used in a combinatorial fashion. Resection of the AVM nidus affords high rates of immediate obliteration, but it is invasive and carries a moderate risk of neurologic morbidity. AVM embolization is minimally invasive, but cure can only be achieved in a minority of lesions. SRS is also minimally invasive and has little immediate morbidity, but AVM obliteration occurs in a delayed fashion, so the patient remains at risk of hemorrhage during the latency period. Whether obliteration can be achieved in unruptured AVMs with a lower risk of stroke or death compared with the natural history of AVMs remains controversial. Over the past 5 years, multicenter prospective and retrospective studies describing AVM natural history and treatment outcomes have been published. This review provides a contemporary and comprehensive discussion of the natural history, pathobiology, and interventions for brain AVMs.

RADIOSURGERY TO REDUCE THE RISK OF FIRST HEMORRHAGE FROM BRAIN ARTERIOVENOUS MALFORMATIONS

Neurosurgery ◽  
2007 ◽  
Vol 60 (3) ◽  
pp. 453-459 ◽  
Author(s):  
Keisuke Maruyama ◽  
Masahiro Shin ◽  
Masao Tago ◽  
Junji Kishimoto ◽  
Akio Morita ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Stereotactic Radiosurgery ◽  
Arteriovenous Malformations ◽  
Gamma Knife Radiosurgery ◽  
Latency Period ◽  
Hazard Ratio ◽  
Cox Proportional Hazards Model ◽  
Brain Arteriovenous Malformations ◽  
Risk Of Hemorrhage ◽  
Observation Period

Abstract OBJECTIVE It remains unclear whether or not and to what extent stereotactic radiosurgery can reduce the risk of first intracranial hemorrhage from brain arteriovenous malformations. METHODS We performed a retrospective observational investigation of 500 patients with arteriovenous malformations who were treated with gamma knife radiosurgery. The risk of first hemorrhage was analyzed using the Cox proportional-hazards model with age at radiosurgery and angiographic obliteration included as time-dependent covariates. Three periods were defined: from birth to radiosurgery (before radiosurgery); from radiosurgery to angiographic obliteration (latency period); and from angiographic obliteration to end of the follow-up period (after obliteration). RESULTS Hemorrhage was documented before radiosurgery in 318 patients (median observation period, 30.0 yr), during the latency period in 11 patients (median observation period, 2.2 yr), and after obliteration in two patients (median observation period, 5.5 yr). Compared with the period before radiosurgery, the risk of hemorrhage decreased by 86% after obliteration (hazard ratio, 0.14; 95% confidence interval, 0.03–0.55; P = 0.005), whereas the reduction observed during the latency period was not statistically significant (hazard ratio, 0.56; 95% confidence interval, 0.31–1.04; P = 0.07). Irrespective of obliteration, the risk of hemorrhage decreased by 62% after radiosurgery (hazard ratio, 0.38; 95% confidence interval, 0.22–0.67; P = 0.001). Similar results were observed when the 33 patients who had undergone previous therapy were excluded from the analysis. CONCLUSION Stereotactic radiosurgery significantly reduces the risk of first hemorrhage from brain arteriovenous malformations. The extent of the decrease might be greater if angiography indicates the evidence of obliteration.

scholarly journals Relative risk of hemorrhage during pregnancy in patients with brain arteriovenous malformations

2017 ◽  
Vol 12 (7) ◽  
pp. 741-747 ◽  
Author(s):  
Janneke van Beijnum ◽  
Tim Wilkinson ◽  
Heather J Whitaker ◽  
Johanna G van der Bom ◽  
Ale Algra ◽  
...  
Keyword(s):  
Relative Risk ◽  
Arteriovenous Malformations ◽  
Brain Arteriovenous Malformations ◽  
Risk Of Hemorrhage

scholarly journals The CTSC-RAB38 Fusion Transcript Is Associated With the Risk of Hemorrhage in Brain Arteriovenous Malformations

2020 ◽  
Vol 80 (1) ◽  
pp. 71-78
Author(s):  
Zihan Yan ◽  
Guangming Fan ◽  
Hao Li ◽  
Yuming Jiao ◽  
Weilun Fu ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Chromosomal Rearrangements ◽  
Fusion Transcript ◽  
Fusion Genes ◽  
Inflammatory Signaling ◽  
Fusion Transcripts ◽  
Brain Arteriovenous Malformations ◽  
Functional Pathway ◽  
Fusion Analysis ◽  
Risk Of Hemorrhage

Abstract Brain arteriovenous malformations (bAVMs) are congenital anomalies of blood vessels that cause intracranial hemorrhage in children and young adults. Chromosomal rearrangements and fusion genes play an important role in tumor pathogenesis, though the role of fusion genes in bAVM pathophysiological processes is unclear. The aim of this study was to identify fusion transcripts in bAVMs and analyze their effects. To identify fusion transcripts associated with bAVM, RNA sequencing was performed on 73 samples, including 66 bAVM and 7 normal cerebrovascular samples, followed by STAR-Fusion analysis. Reverse transcription polymerase chain reaction and Sanger sequencing were applied to verify fusion transcripts. Functional pathway analysis was performed to identify potential effects of different fusion types. A total of 21 fusion transcripts were detected. Cathepsin C (CTSC)-Ras-Related Protein Rab-38 (RAB38) was the most common fusion and was detected in 10 of 66 (15%) bAVM samples. In CTSC-RAB38 fusion-positive samples, CTSC and RAB38 expression was significantly increased and activated immune/inflammatory signaling. Clinically, CTSC-RAB38 fusion bAVM cases had a higher hemorrhage rate than non-CTSC-RAB38 bAVM cases (p < 0.05). Our study identified recurrent CTSC-RAB38 fusion transcripts in bAVMs, which may be associated with bAVM hemorrhage by promoting immune/inflammatory signaling.

Management of Unruptured Brain Arteriovenous Malformations

US Neurology ◽  
2014 ◽  
Vol 10 (02) ◽  
pp. 120
Author(s):  
Andrew F Ducruet ◽  
Robert M Friedlander ◽  
◽  
Keyword(s):  
Arteriovenous Malformations ◽  
Significant Morbidity ◽  
High Profile ◽  
Brain Arteriovenous Malformations ◽  
Risk Of Hemorrhage

Brain arteriovenous malformations (bAVMs) portent a lifelong risk of hemorrhage but the treatment of these lesions may also be associated with significant morbidity. Two recent high-profile studies have suggested that patients undergoing treatment of bAVMs may suffer a worse outcome than patients managed conservatively. However, both of these studies suffer from significant limitations that limit the conclusions that can be drawn. Further work, including the establishment of a prospective registry, is necessary to definitively address this matter.

Treatment of brain arteriovenous malformations by embolization and radiosurgery

1996 ◽  
Vol 85 (1) ◽  
pp. 19-28 ◽  
Author(s):  
Y. Pierre Gobin ◽  
Alexandre Laurent ◽  
Louis Merienne ◽  
Maurice Schlienger ◽  
Armand Aymard ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Morbidity Rate ◽  
Total Occlusion ◽  
Content Type ◽  
Brain Arteriovenous Malformations ◽  
History Of ◽  
Grade Ii ◽  
Risk Of Hemorrhage ◽  
Grade Iii

✓ Embolization was used to reduce the size of brain arteriovenous malformations (AVMs) prior to radiosurgical treatment in 125 patients who were poor surgical candidates or had refused surgery. Of these patients, 81% had suffered hemorrhage, and 22.4% had undergone treatment at another institution. According to the Spetzler—Martin scale, the AVMs were Grade II in 9.6%, Grade III in 31.2%, Grade IV in 30.4%, and Grades V to VI in 28.8% of the cases. Most embolizations were performed using cyanoacrylate delivered by flow-guided microcatheters. Radiosurgery was performed using a linear accelerator in 62 patients treated by the authors, and 34 patients were treated at other institutions using various methods. Embolization produced total occlusion in 11.2% of AVMs and reduced 76% of AVMs enough to allow radiosurgery. Radiosurgery produced total occlusion in 65% of the partially embolized AVMs (79% when the residual nidus was < 2 cm in diameter). Embolizations resulted in a mortality rate of 1.6% and a morbidity rate of 12.8%. No complications were associated with radiosurgery. The hemorrhage rate for partially embolized AVMs was 3% per year. No patient with a completely occluded AVM experienced rehemorrhage. Angiographic follow-up review of AVMs embolized with cyanoacrylate demonstrated a 11.8% revascularization rate, occurring within 1 year. It is concluded that after partial embolization with cyanoacrylate, the risk of hemorrhage from the residual nidus is comparable to the natural history of AVMs and that the residual nidus can be irradiated with results almost as good as for a native AVM of the same size.

scholarly journals Homocysteine Level and Risk of Hemorrhage in Brain Arteriovenous Malformations

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Chaofan Zeng ◽  
Fa Lin ◽  
Peicong Ge ◽  
Dong Zhang ◽  
Shuo Wang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Lower Risk ◽  
Arteriovenous Malformations ◽  
Maximum Diameter ◽  
Brain Arteriovenous Malformations ◽  
Risk Of Rupture ◽  
Laboratory Variables ◽  
Risk Of Hemorrhage

Objective. We aimed to investigate the risk factors associated with hemorrhage and clarify the relation of homocysteine (Hcy) with brain arteriovenous malformations (bAVMs). Method. We retrospectively reviewed bAVM patients from Beijing Tiantan Hospital between January 2019 and December 2019. Clinical and laboratory variables were analyzed in enrolled patients with bAVMs. Potential predictors associated with hemorrhage were evaluated by logistic regression analysis. Results. A total of 143 bAVM patients were identified in the study, including 69 unruptured and 74 ruptured cases. Patients with hemorrhage were less likely to have hyperhomocysteinemia ( P = 0.023 ). Logistic regression analysis showed that increased maximum diameter of bAVM lesions (odds ratio (OR) 0.634, 95% confidence intervals (CI) 0.479-0.839; P = 0.001 ) and serum Hcy level (OR 0.956, 95% CI 0.920-0.993; P = 0.021 ) were associated with lower risk of hemorrhage in bAVMs. Conclusion. The present study provided evidence regarding the association between serum Hcy and hemorrhage in patients with bAVMs. Higher Hcy level was correlated with a lower risk of rupture. Detection of factors for subsequent hemorrhage is necessary to develop therapeutic strategies for bAVMs preferably.

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