Abstract Details

Title Clinical and Radiographic Features of Multiple Intracranial Arteriovenous Malformations

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-023

Objective To investigate clinical and radiographic characteristics of patients with multiple intracranial arteriovenous malformations (AVM).

Background

Solitary intracranial AVMs are thought to be sporadic as compared to AVM multiplicity, which tends to be present in patients with predisposing genetic diseases [i.e. hereditary hemorrhagic telangiectasia (HHT)]. Little is known about the differences between the two groups. We aimed to determine clinical, demographic and radiographic differences between patients with solitary vs. multiple intracranial AVMs.

Design/Methods Consecutive patients with radiographic diagnosis of AVM seen at Mayo Clinic Rochester (2000-2015) were included. Demographic, clinical and radiographic data were abstracted. For patients with multiple intracranial AVMs, radiographic data were obtained separately for each nidus, including number of AVM nidi, nidus location, laterality, size, venous drainage pattern, feeding or intranidal artery aneurysm, and Spetzler-Martin grade. A neuroradiologist reviewed all imaging studies. Fisher’s exact test was performed for categorical variables, and two-sample t-test for continuous variables. Significant p-value was 0.05.

Results There were 502 AVM nidi across a total of 455 patients. Nineteen patients had multiple intracranial AVMs, of which there were 66 AVMs identified. HHT was more frequently seen in patients with multiple AVMs (n= 13, 68.4%), compared to patients with solitary AVMs (n=6, 1.4%) (p<0.0001). Patients with multiple AVMs were typically younger and presented incidentally (non-significant trend). Several significant radiographic differences were noted between patients with solitary and multiple AVMs (p<0.05). Specifically, solitary AVMs were more often of larger size (>3 cm), and were associated with i) higher Spetzler-Martin grade (>3), ii) presence of deep or both deep and superficial venous drainage, iii) presence of feeding and intranidal artery aneurysms.

Conclusions We identified clinical and radiographic differences between patients with solitary and multiple intracranial AVMs. Further research is needed to investigate prospective intracranial hemorrhage and annual hemorrhage incidence rate in patients with AVM multiplicity.

Authors/Disclosures
Shannon Y. Chiu, MD, MSc (Mayo Clinic Arizona) PRESENTER	Dr. Chiu has received research support from NIH.
Deena Nasr, DO (Mayo Clinic)	Dr. Nasr has nothing to disclose.
Kelly D. Flemming, MD (Mayo Clinic)	Dr. Flemming has nothing to disclose.
Waleed Brinjikji, MD (Mayo Clinic)	Waleed Brinjikji, MD has nothing to disclose.
Giuseppe Lanzino, MD (Mayo Clinic)	Dr. Lanzino has nothing to disclose.

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