Multivariate Analysis Of Clinical And Vascular Risk Factors Of Cerebral Arteriovenous Malformations With Hemorrhagic Presentation

Objective The goal of this study was to explore the correlation of clinical and vascular factors of cerebral arteriovenous malformations(AVMs) with presentation of hemorrhage, and identify the risk factors of hemorrhage in order to guide clinical management.Methods A retrospective analysis of 112 patients with AVMs was conducted. Clinical and vascular parameters were evaluated using univariate analysis and multivariate logistic regression analysis to assess factors associated with hemorrhagic presentation.Results This group had a mean age of 32.6 years, 51.8% (58/112) were men and 47.3%(53/112) presented withspontaneous intracranial hemorrhage. Five of 7 patients with hypertension presented with hemorrhage. By univariate analysis, deep-seated AVMs, small AVMs, deep venous drainage , a single draining vein and intranidal aneurysm were associated with hemorrhagic presentation. There was no statistically significant relationship between gender, age, type of arterial feeders, type of nidus, stenosis of draining vein and AVM hemorrhage. When multivariate logistic regression analysis was applied, only deep-seated AVM and a single draining vein were associated with presentation of hemorrhage. Small size, deep venous drainage and intranidal aneurysm did not independently correlate with hemorrhagic presentation.Conclusion The probability of hemorrhagic presentation in patients with cerebral AVMs is associated with multiple risk factors. Deep-seated location and a single draining vein are the independent risk factors.