title: Angioarchitectural features of brain arteriovenous malformations associated with seizures: a single center retrospective series.
abstract: OBJECTIVE
  Epileptic seizures account for 24-40% of all clinical onsets in patients with brain arteriovenous malformations (AVMs).
  
  
  METHODS
  We retrospectively reviewed the angioarchitectural features of AVMs associated with seizures in 168 patients admitted to our Department from 1997 to 2012. Patients were dichotomized according to demographic characteristics, type of treatment, bleeding occurrence, and morphological and topographic features. Clinical status at admission and discharge was also recorded. The association of each one of these variables with seizures occurrence was statistically tested. Continuous variables and outcome were compared with Student's t-test, whereas categorical ones were compared using Fisher's exact test. The independent contribution of some seizures predictors was assessed with a logistic regression model. Associations were considered significant for P < 0.05.
  
  
  RESULTS
  About 29% patients showed seizures and 47% bleeding. No significant difference in age and sex was observed between patients with and without seizures. AVMs > 4 cm (P = 0.001) and those fed by dilated arterial feeders (P = 0.02) were associated with increased risk of seizures. A higher risk of seizures occurrence was also observed in cortical AVMs compared with deeper ones (75.5% vs. 55.4%; P = 0.01), and in AVMs fed by middle and posterior cerebral arteries branches compared with the other vessels (81.6% vs. 45.3%; P < 0.001 and 48.9% vs. 23.5%; P = 0.002, respectively). No lobar predisposition was observed. A nidus > 4 cm also appeared as an independent risk factor of seizures occurrence (OR 2.82; 95% CI, 1.26-6.31; P = 0.009) at logistic regression analysis.
  
  
  CONCLUSIONS
  AVM morphology, especially nidus dimension, appeared to more significantly influence seizures occurrence than their topography.
authors.affiliation: Institute of Neurosurgery, Catholic University School of Medicine, Rome, Italy. cropcircle.2000@virgilio.it
authors.forename: C L
authors.initials: CL
authors.lastname: Sturiale
authors.forename: L
authors.initials: L
authors.lastname: Rigante
authors.forename: A
authors.initials: A
authors.lastname: Puca
authors.forename: G
authors.initials: G
authors.lastname: Di Lella
authors.forename: A
authors.initials: A
authors.lastname: Albanese
authors.forename: E
authors.initials: E
authors.lastname: Marchese
authors.forename: C
authors.initials: C
authors.lastname: Di Rocco
authors.forename: G
authors.initials: G
authors.lastname: Maira
authors.forename: G
authors.initials: G
authors.lastname: Colicchio
mesh_terms: D000328:Adult; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging; D004827:Epilepsy / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors