title: Clinical Features of Superficially Located Brain Arteriovenous Malformations with Transdural Arterial Communication.
abstract: BACKGROUND
  Contrary to deeply located brain arteriovenous malformations (AVMs), superficially located AVMs are more likely to have transdural arterial communications (TACs). However, the clinical and radiologic characteristics of patients presenting with AVMs and TACs are poorly understood. The purpose of this study is to determine whether clinicoradiological features of cerebral AVMs differ according to TAC.
  
  
  METHODS
  Between 2002 and 2012, 438 consecutive patients with a brain AVM were treated in our hospital. Among them were 124 patients with superficially located brain AVMs who met the inclusion and exclusion criteria of our study. We retrospectively reviewed the clinicoradiological features of their TACs to explore the variation in characteristics.
  
  
  RESULTS
  Thirty-two of the 124 patients with a superficially located AVM (25.8%) had TAC. Radiologic findings of brain AVM images with TAC showed that TAC occurred significantly more frequently among larger AVMs (with vs. without TAC, 11.2 vs. 4.0 ml) and among diffuse AVMs (56.3 vs. 28.3%, p = 0.004). Clinical findings indicate that TAC was associated with chronic headache (43.8 vs. 12.0%, p < 0.001) and older age (43.1 vs. 36.6 years, p = 0.037).
  
  
  CONCLUSIONS
  Brain AVM with TAC seems to be accompanied by distinctive clinical features, such as chronic headache and older age. Larger size and diffuseness of the AVM were also associated with TAC. Findings from this study and the prognostic significance of TAC should be further explored in a large prospective study.
authors.affiliation: Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hae-Won
authors.initials: HW
authors.lastname: Koo
authors.forename: Kyung-Il
authors.initials: KI
authors.lastname: Jo
authors.forename: Je-Young
authors.initials: JY
authors.lastname: Yeon
authors.forename: Keon Ha
authors.initials: KH
authors.lastname: Kim
authors.forename: Pyoung
authors.initials: P
authors.lastname: Jeon
authors.forename: Jong-Soo
authors.initials: JS
authors.lastname: Kim
authors.forename: Seung-Chyul
authors.initials: SC
authors.lastname: Hong
authors.forename: Hyung Jin
authors.initials: HJ
authors.lastname: Shin
authors.forename: Jung-Il
authors.initials: JI
authors.lastname: Lee
mesh_terms: D000368:Aged; D001158:Arteries / Q000503:physiopathology*; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D002533:Cerebral Angiography / Q000379:methods; D002543:Cerebral Hemorrhage / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D012189:Retrospective Studies