title: Increased prevalence and rupture status of feeder vessel aneurysms in posterior fossa arteriovenous malformations.
abstract: Posterior fossa arteriovenous malformations (AVMs) are considered to have a higher risk of poor outcome, as are AVMs with associated aneurysms. We postulated that posterior fossa malformations may be more prone to associated feeder vessel aneurysms, and to aneurysmal source of hemorrhage.
  
  
  
  To examine the prevalence and hemorrhagic risk of posterior fossa AVM-associated feeder vessel aneurysms.
  
  
  
  A retrospective review of AVMs was performed with attention paid to location and presence of aneurysms. The hemorrhage status and origin of the hemorrhage was also reviewed.
  
  
  
  571 AVMs were analyzed. Of 90 posterior fossa AVMs, 34 (37.8%) had aneurysms (85% feeder vessel, 9% intranidal, 15% with both). Of the 481 supratentorial AVMs, 126 (26.2%) harbored aneurysms (65% feeder vessel, 29% intranidal, 6% both). The overall incidence of feeder aneurysms was higher in posterior fossa AVMs, which were evident in 34.4% of infratentorial AVMs compared to 18.5% of supratentorial malformations (p<0.01). The presence of intranidal aneurysms was similar in both groups (9.2% vs 8.8%). Feeder artery aneurysms were much more likely to be the source of hemorrhage in posterior fossa AVMs than in supratentorial AVMs (30% vs 7.6%, p<0.01).
  
  
  
  Posterior fossa AVMs are more prone to developing associated aneurysms, specifically feeder vessel aneurysms. Feeder vessel aneurysms are more likely to be the source of hemorrhage in the posterior fossa. As such, they may be the most appropriate targets for initial and prompt control by embolization or surgery due to their elevated threat.
authors.affiliation: Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Orning
authors.affiliation: Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Amin-Hanjani
authors.affiliation: Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Youssef J
authors.initials: YJ
authors.lastname: Hamade
authors.affiliation: Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Xinjian
authors.initials: X
authors.lastname: Du
authors.affiliation: Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Hage
authors.affiliation: Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Aletich
authors.affiliation: Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Fady
authors.initials: F
authors.lastname: Charbel
authors.affiliation: Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Alaraj
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D001808:Blood Vessels / Q000473:pathology; D002533:Cerebral Angiography; D002648:Child; D002675:Child, Preschool; D003388:Cranial Fossa, Posterior / Q000473:pathology* / Q000601:surgery; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D002532:Intracranial Aneurysm / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D002538:Intracranial Arteriovenous Malformations / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D020300:Intracranial Hemorrhages / Q000209:etiology; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D015995:Prevalence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Aneurysm; Arteriovenous Malformation; Hemorrhage; Posterior fossa; Subarachnoid