Clinical relevance of associated aneurysms with arteriovenous malformations of the posterior fossa.

Nils-Ole Schmidt; Matthias Reitz; Frank Raimund; András Treszl; Ulrich Grzyska; Manfred Westphal; Jan Regelsberger

Clinical relevance of associated aneurysms with arteriovenous malformations of the posterior fossa.

Standard

Clinical relevance of associated aneurysms with arteriovenous malformations of the posterior fossa. / Schmidt, Nils-Ole; Reitz, Matthias; Raimund, Frank; Treszl, András; Grzyska, Ulrich; Westphal, Manfred; Regelsberger, Jan.

in: ACTA NEUROCHIR SUPPL, Jahrgang 112, 2011, S. 131-135.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Schmidt, N-O, Reitz, M, Raimund, F, Treszl, A, Grzyska, U, Westphal, M & Regelsberger, J 2011, 'Clinical relevance of associated aneurysms with arteriovenous malformations of the posterior fossa.', ACTA NEUROCHIR SUPPL, Jg. 112, S. 131-135. <http://www.ncbi.nlm.nih.gov/pubmed/21692001?dopt=Citation>

APA

Schmidt, N-O., Reitz, M., Raimund, F., Treszl, A., Grzyska, U., Westphal, M., & Regelsberger, J. (2011). Clinical relevance of associated aneurysms with arteriovenous malformations of the posterior fossa. ACTA NEUROCHIR SUPPL, 112, 131-135. http://www.ncbi.nlm.nih.gov/pubmed/21692001?dopt=Citation

Vancouver

Schmidt N-O, Reitz M, Raimund F, Treszl A, Grzyska U, Westphal M et al. Clinical relevance of associated aneurysms with arteriovenous malformations of the posterior fossa. ACTA NEUROCHIR SUPPL. 2011;112:131-135.

Bibtex

@article{5c4cc57e6d5d4dd58225cd5f77857e93,

title = "Clinical relevance of associated aneurysms with arteriovenous malformations of the posterior fossa.",

abstract = "The aim of this study was to determine the frequency of aneurysms associated with arteriovenous malformations (AVMs) of the posterior fossa and their relation to hemorrhagic presentation in comparison to supratentorial AVMs. We performed a retrospective analysis of 474 patients with intracranial AVMs treated in our center from 1990 to 2010. Patients were analyzed for AVM size, drainage type and their clinical course with focus on vessel anomalies including AVM-associated aneurysms. Seventeen (30%) of 57 posterior fossa AVMs versus 46 (11%) of 417 supratentorial AVMs were associated with aneurysms. In six (10.5%) versus seven (1.7%) patients, respectively, flow-associated aneurysms were the source of hemorrhage. Infratentorial location of an AVM was a significant risk factor for the incidence (p <0.001) and rupture (p <0.001) of AVM-associated aneurysms. Feeding artery aneurysms in particular represented a risk factor for hemorrhage in the overall group of AVM patients, independently of the location (p <0.001). The majority of patients with a posterior fossa AVM were treated by combined embolization and surgical removal within one procedure (n = 33, 58%). Feeding artery aneurysms were excluded by endovascular coiling or surgical clipping whenever feasible. Overall treatment-associated permanent morbidity in the subgroup of posterior fossa AVMs was 11% (n = 6) and mortality 4% (n = 2). Posterior fossa AVMs display a significantly higher frequency of associated aneurysms of the adjacent vessels that are correlated to the high bleeding rate compared to AVMs of the supratentorial compartment. We therefore recommend aggressive AVM treatment including the exclusion of associated aneurysms as a minimal therapeutic goal whenever possible.",

keywords = "Adult, Humans, Male, Aged, Female, Middle Aged, Aged, 80 and over, Adolescent, Young Adult, Treatment Outcome, Child, Follow-Up Studies, Child, Preschool, Infant, Retrospective Studies, Magnetic Resonance Imaging, Cerebral Angiography, Endovascular Procedures/methods, Arteriovenous Malformations/*complications/*pathology/surgery, Intracranial Aneurysm/*complications/surgery, Surgical Instruments, Adult, Humans, Male, Aged, Female, Middle Aged, Aged, 80 and over, Adolescent, Young Adult, Treatment Outcome, Child, Follow-Up Studies, Child, Preschool, Infant, Retrospective Studies, Magnetic Resonance Imaging, Cerebral Angiography, Endovascular Procedures/methods, Arteriovenous Malformations/*complications/*pathology/surgery, Intracranial Aneurysm/*complications/surgery, Surgical Instruments",

author = "Nils-Ole Schmidt and Matthias Reitz and Frank Raimund and Andr{\'a}s Treszl and Ulrich Grzyska and Manfred Westphal and Jan Regelsberger",

year = "2011",

language = "English",

volume = "112",

pages = "131--135",

journal = "ACTA NEUROCHIR SUPPL",

issn = "0065-1419",

publisher = "Springer Wien",

}

RIS

TY - JOUR

T1 - Clinical relevance of associated aneurysms with arteriovenous malformations of the posterior fossa.

AU - Schmidt, Nils-Ole

AU - Reitz, Matthias

AU - Raimund, Frank

AU - Treszl, András

AU - Grzyska, Ulrich

AU - Westphal, Manfred

AU - Regelsberger, Jan

PY - 2011

Y1 - 2011

N2 - The aim of this study was to determine the frequency of aneurysms associated with arteriovenous malformations (AVMs) of the posterior fossa and their relation to hemorrhagic presentation in comparison to supratentorial AVMs. We performed a retrospective analysis of 474 patients with intracranial AVMs treated in our center from 1990 to 2010. Patients were analyzed for AVM size, drainage type and their clinical course with focus on vessel anomalies including AVM-associated aneurysms. Seventeen (30%) of 57 posterior fossa AVMs versus 46 (11%) of 417 supratentorial AVMs were associated with aneurysms. In six (10.5%) versus seven (1.7%) patients, respectively, flow-associated aneurysms were the source of hemorrhage. Infratentorial location of an AVM was a significant risk factor for the incidence (p <0.001) and rupture (p <0.001) of AVM-associated aneurysms. Feeding artery aneurysms in particular represented a risk factor for hemorrhage in the overall group of AVM patients, independently of the location (p <0.001). The majority of patients with a posterior fossa AVM were treated by combined embolization and surgical removal within one procedure (n = 33, 58%). Feeding artery aneurysms were excluded by endovascular coiling or surgical clipping whenever feasible. Overall treatment-associated permanent morbidity in the subgroup of posterior fossa AVMs was 11% (n = 6) and mortality 4% (n = 2). Posterior fossa AVMs display a significantly higher frequency of associated aneurysms of the adjacent vessels that are correlated to the high bleeding rate compared to AVMs of the supratentorial compartment. We therefore recommend aggressive AVM treatment including the exclusion of associated aneurysms as a minimal therapeutic goal whenever possible.

AB - The aim of this study was to determine the frequency of aneurysms associated with arteriovenous malformations (AVMs) of the posterior fossa and their relation to hemorrhagic presentation in comparison to supratentorial AVMs. We performed a retrospective analysis of 474 patients with intracranial AVMs treated in our center from 1990 to 2010. Patients were analyzed for AVM size, drainage type and their clinical course with focus on vessel anomalies including AVM-associated aneurysms. Seventeen (30%) of 57 posterior fossa AVMs versus 46 (11%) of 417 supratentorial AVMs were associated with aneurysms. In six (10.5%) versus seven (1.7%) patients, respectively, flow-associated aneurysms were the source of hemorrhage. Infratentorial location of an AVM was a significant risk factor for the incidence (p <0.001) and rupture (p <0.001) of AVM-associated aneurysms. Feeding artery aneurysms in particular represented a risk factor for hemorrhage in the overall group of AVM patients, independently of the location (p <0.001). The majority of patients with a posterior fossa AVM were treated by combined embolization and surgical removal within one procedure (n = 33, 58%). Feeding artery aneurysms were excluded by endovascular coiling or surgical clipping whenever feasible. Overall treatment-associated permanent morbidity in the subgroup of posterior fossa AVMs was 11% (n = 6) and mortality 4% (n = 2). Posterior fossa AVMs display a significantly higher frequency of associated aneurysms of the adjacent vessels that are correlated to the high bleeding rate compared to AVMs of the supratentorial compartment. We therefore recommend aggressive AVM treatment including the exclusion of associated aneurysms as a minimal therapeutic goal whenever possible.

KW - Adult

KW - Humans

KW - Male

KW - Aged

KW - Female

KW - Middle Aged

KW - Aged, 80 and over

KW - Adolescent

KW - Young Adult

KW - Treatment Outcome

KW - Child

KW - Follow-Up Studies

KW - Child, Preschool

KW - Infant

KW - Retrospective Studies

KW - Magnetic Resonance Imaging

KW - Cerebral Angiography

KW - Endovascular Procedures/methods

KW - Arteriovenous Malformations/complications/pathology/surgery

KW - Intracranial Aneurysm/complications/surgery

KW - Surgical Instruments