Effect of age on clinical and morphological characteristics in patients with brain arteriovenous malformation.
OBJECTIVE
The goal of this work was to determine the effect of age at initial presentation on clinical and morphological characteristics in patients with brain arteriovenous malformation (AVM).


METHODS
The 542 consecutive patients from the prospective Columbia AVM database (mean+/-SD age, 34+/-15 years) were analyzed. Univariate statistical models were used to test the effect of age at initial presentation on clinical (AVM hemorrhage, seizures, headaches, neurological deficit, other/asymptomatic) and morphological (AVM size, venous drainage pattern, AVM brain location, concurrent arterial aneurysms) characteristics.


RESULTS
Hemorrhage was the presenting symptom in 46% (n=247); 29% (n=155) presented with seizures, 13% (n=71) with headaches, 7% (n=36) with a neurological deficit, and 6% (n=33) without AVM-related symptoms. Increasing age correlated positively with intracranial hemorrhage (P=0.001), focal neurological deficits (P=0.007), infratentorial AVMs (P<0.001), and concurrent arterial aneurysms (P<0.001); an inverse correlation was found with seizures (P<0.001), AVM size (P=0.001), and lobar (P<0.001), deep (P=0.008), and borderzone (P=0.014) location. No age differences were found for sex, headache, asymptomatic presentation, and venous drainage pattern.


CONCLUSIONS
Our data suggest a significant interaction of patient age and clinical and morphological AVM features and argue against uniform AVM characteristics across different age classes at initial presentation. In particular, AVM patients diagnosed at a higher age show a higher fraction of AVM hemorrhage and are more likely to harbor additional risk factors such as concurrent arterial aneurysms and small AVM diameter. Longitudinal population-based AVM data are necessary to confirm these findings.
Stroke Center, Neurological Institute, Columbia University College of Physicians and Surgeons, 710 W 168th St, New York, NY 10032, USA. cstapf@neuro.columbia.edu
C
C
Stapf
A V
AV
Khaw
R R
RR
Sciacca
C
C
Hofmeister
H C
HC
Schumacher
J
J
Pile-Spellman
H
H
Mast
J P
JP
Mohr
A
A
Hartmann
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology; D002648:Child; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D012640:Seizures / Q000175:diagnosis / Q000209:etiology; D014057:Tomography, X-Ray Computed