title: Early regrowth of juvenile cerebral arteriovenous malformations: report of 3 cases and immunohistochemical analysis.
abstract: BACKGROUND
  Regrowth of cerebral AVMs after angiographically documented obliteration has been observed in children. In addition, AVMs in adults are reported to be at risk of regrowth despite an angiogram confirming complete removal. However, the mechanism by which regrowth occurs has not been clarified; neither is it clear when regrowth occurs after removal.
  
  
  METHODS
  We report 3 cases showing regrowth of AVMs on postoperative angiogram performed 3 months after surgery. We also analyzed the protein levels of various factors that may influence AVM regrowth. Using immunohistochemistry, we analyzed the protein levels of the following factors: CD31 (PECAM), CD34, and CD105 (endoglin), which are endothelial or endothelial progenitor markers; VEGF, a growth factor that may influence AVM regrowth; and PCNA, a marker of proliferating cells. In addition, we analyzed the level of pERK.
  
  
  CONCLUSIONS
  We report 3 cases of early regrowth of cerebral AVMs. In recurrent AVM samples obtained at second operations, increased levels of perivascular CD105 and pERK immunoreactivity were seen.
authors.affiliation: Department of Neurosurgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan. ytakagi@kuhp.kyoto-u.ac.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takagi
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: Kikuta
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nozaki
authors.forename: Nobuo
authors.initials: N
authors.lastname: Hashimoto
mesh_terms: D015703:Antigens, CD / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis* / Q000378:metabolism* / Q000628:therapy; D008297:Male; D020928:Mitogen-Activated Protein Kinases / Q000378:metabolism; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism; D012008:Recurrence; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D015703:Antigens, CD; D018809:Proliferating Cell Nuclear Antigen; D042461:Vascular Endothelial Growth Factor A; D020928:Mitogen-Activated Protein Kinases