Clinical Analysis Of 155 Cases Of Brain Arteriovenous Malformation

Objective:To analyze the effect of age,sex,location of lesion,feeding artery and blood flow-related aneurysm on the first symptoms(intracranial hemorrhage and epilepsy)of patients with brain arteriovenous malformation,and to simply explore the efficacy of intervention in the treatment of patients with unruptured brain arteriovenous malformation,providing reference.for clinical treatment.Methods:The demographic data,clinical features,blood tube morphological characteristics,treatment methods and follow-up of patients with brain arteriovenous malformation diagnosed by head and neck CT angiography(CTA),cerebral angiography(DSA)or pathology from January 2018 to December 2019 in the Department of Neurology,the First Affiliated Hospital of Guangxi Medical University were analyzed.Results:A total of 155 patients with brain arteriovenous malformations were collected.The mean age was(30.4 ±13.8)years,88(56.8%)were male and67(43.2%)were female,with a male to female ratio of approximately1.31:1.Clinical features: The common initial clinical manifestationsof brain arteriovenous malformation were intracranial hemorrhage in 102 cases(65.8%),epilepsy in 19 cases(12.3%),headache in 16 cases(10.3%),and neurological deficits in 9 cases(5.8%).Factors affecting first symptoms: Age less than 10years(P < 0.05,OR = 6.933,95% Cl 0.876 –54.856),deep lesions(P < 0.05,OR = 9.674,95% Cl 1.246 – 75.016)and arterial borderzone location(P < 0.05,OR = 0.332,95% Cl 0.166 – 0.662)were associated with intracranial hemorrhage.Male gender(P < 0.05,OR = 3.236,95% Cl 1.021–10.257),frontal lobe lesions(P < 0.05,OR = 4.478,95% Cl 1.596 –12.566)and watershed lesions(P < 0.05,OR = 2.936,95% Cl 1.076 – 8.009)were associated with seizures.Treatment: Of the 48patients(30.3%)without ruptured brain arteriovenous malformations,25(53.2%)received intervention,including embolization alone in 12 patients(48.0%),radiotherapy alone in 6 patients(24.0%),surgical resection alonein4 patients(16.0%),and embolization combined with radiotherapy in 3 patients(12.0%).Twenty-four patients(96.0%)had S-M grade I and II,and 1 patient(4.0%)had grade III,with m RS scores of0–1 before treatment.The mean follow-up was 11.1 months(range,4 –27months).The difference in the m RS scores of 24 patients before and after treatment had statistical significance(P <0.001),and all patients achieved good prognosis;1 patient(4.2%)had bleeding during follow-up,which occurred after the secondembolization in patients with S-M grade III,and there was no disability or rebleeding at the end of follow-up;no complications occurred in grade I and II.Conclusion:1.age < 10 years and deep lesions lead to an increased risk of intracranial hemorrhage in patients with brain arteriovenous malformations,while arterial borderzone location reduce the risk of hemorrhage.2.male sex,frontal lobe and watershed areas lead to an increased risk of epilepsy in patients with brain arteriovenous malformations.3.patients with unruptured brain arteriovenous malformations of S-M grade I and II treated with intervention have a better prognosis and a low incidence of complications.