Relationships between hemorrhage, angioarchitectural factors and collagen of arteriovenous malformations.
OBJECTIVE
While associations between the angioarchitecture of arteriovenous malformations (AVMs) in the brain and pathological features have been described, here we investigated the relationship between the angioarchitecture, the pathological features of the vessel wall, and hemorrhagic events.


METHODS
The study was conducted on 43 patients: 16 with ruptured AVM (rAVM), 15 with non-ruptured AVM (nrAVM), 6 with craniocerebral trauma (control) and 6 with epilepsy (control). The diagnosis of AVM was confirmed by preoperative digital subtraction angiography. Tissues were stained with hematoxylin and eosin and Masson's trichrome (for collagen fibers) to evaluate the vessel wall structure and endothelial integrity. The content and distribution of collagen types I and III in the vessel wall were assessed by immunohistochemical staining.


RESULTS
In the nrAVM group, the nidus had more draining veins than the rAVM group (P <0.05). Severely damaged endothelial cells, significantly fewer smooth muscle cells in the media, and hyperplasic type-I and -III collagen fibers were found in the rAVM group. The content of collagen types I and III in rAVMs was higher than that in the nrAVM (P <0.05) and control groups (P <0.01).


CONCLUSIONS
There is an association between angioarchitectural features such as the number of draining veins and the pathological structure of the AVM wall. These abnormalities may contribute to AVM rupture.
Department of Neurosurgery, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, 100050, China.
Hongchuan
H
Niu
Yong
Y
Cao
Xuejiang
X
Wang
Xiaowei
X
Xue
Lanbing
L
Yu
Ming
M
Yang
Rong
R
Wang
D000293:Adolescent; D000328:Adult; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology*; D002648:Child; D003094:Collagen / Q000737:chemistry / Q000502:physiology*; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
D003094:Collagen