title: Influence of patient age on angioarchitecture of brain arteriovenous malformations.
abstract: OBJECTIVE
  The imaging characteristics and modes of presentation of brain AVMs may vary with patient age. Our aim was to determine whether clinical and angioarchitectural features of brain AVMs differ between children and adults.
  
  
  METHODS
  A prospectively collected institutional data base of all patients diagnosed with brain AVMs since 2001 was queried. Demographic, clinical, and angioarchitecture information was summarized and analyzed with univariable and multivariable models.
  
  
  RESULTS
  Results often differed when age was treated as a continuous variable as opposed to dividing subjects into children (18 years or younger; n = 203) versus adults (older than 18 years; n = 630). Children were more likely to present with AVM hemorrhage than adults (59% versus 41%, P < .001). Although AVMs with a larger nidus presented at younger ages (mean of 26.8 years for >6 cm compared with 37.1 years for <3 cm), this feature was not significantly different between children and adults (P = .069). Exclusively deep venous drainage was more common in younger subjects when age was treated continuously (P = .04) or dichotomized (P < .001). Venous ectasia was more common with increasing age (mean, 39.4 years with ectasia compared with 31.1 years without ectasia) and when adults were compared with children (52% versus 35%, P < .001). Patients with feeding artery aneurysms presented at a later average age (44.1 years) than those without such aneurysms (31.6 years); this observation persisted when comparing children with adults (13% versus 29%, P < .001).
  
  
  CONCLUSIONS
  Although children with brain AVMs were more likely to come to clinical attention due to hemorrhage than adults, venous ectasia and feeding artery aneurysms were under-represented in children, suggesting that these particular high-risk features take time to develop.
authors.affiliation: From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging steven.hetts@ucsf.edu.
authors.forename: S W
authors.initials: SW
authors.lastname: Hetts
authors.affiliation: From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging.
authors.forename: D L
authors.initials: DL
authors.lastname: Cooke
authors.affiliation: Center for Cerebrovascular Research (J.N., H.K.), Department of Anesthesia and Perioperative Care.
authors.forename: J
authors.initials: J
authors.lastname: Nelson
authors.affiliation: Division of Pediatric Neurosurgery (N.G.)Department of Pediatrics (N.G., H.F.), University of California, San Francisco, San Francisco, California.
authors.forename: N
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Division of Child Neurology (H.F.), Department of NeurologyDepartment of Pediatrics (N.G., H.F.), University of California, San Francisco, San Francisco, California.
authors.forename: H
authors.initials: H
authors.lastname: Fullerton
authors.affiliation: From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging.
authors.forename: M R
authors.initials: MR
authors.lastname: Amans
authors.affiliation: From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging.
authors.forename: J A
authors.initials: JA
authors.lastname: Narvid
authors.affiliation: From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging.
authors.forename: P
authors.initials: P
authors.lastname: Moftakhar
authors.affiliation: From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging.
authors.forename: H
authors.initials: H
authors.lastname: McSwain
authors.affiliation: From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging.
authors.forename: C F
authors.initials: CF
authors.lastname: Dowd
authors.affiliation: From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging.
authors.forename: R T
authors.initials: RT
authors.lastname: Higashida
authors.affiliation: From the Division of Neurointerventional Radiology (S.W.H., D.L.C., M.R.A., J.A.N., P.M., H.M., C.F.D., R.T.H., V.V.H.), Department of Radiology and Biomedical Imaging.
authors.forename: V V
authors.initials: VV
authors.lastname: Halbach
authors.affiliation: Division of Cerebrovascular Neurosurgery (M.T.L.), Department of Neurological Surgery.
authors.forename: M T
authors.initials: MT
authors.lastname: Lawton
authors.affiliation: Center for Cerebrovascular Research (J.N., H.K.), Department of Anesthesia and Perioperative Care.
authors.forename: H
authors.initials: H
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000706:statistics & numerical data; D002140:California / Q000453:epidemiology; D015984:Causality; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult