Xiangke Ma1,2,3,4, Xianzeng Tong1,2,3,4, Jun Wu1,2,3,4, Yong Cao1,2,3,4, Shuo Wang5,6,7,8. 1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, People's Republic of China. 2. China National Clinical Research Center For Neurological Diseases, Beijing, 100050, People's Republic of China. 3. Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, People's Republic of China. 4. Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, 100050, People's Republic of China. 5. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, People's Republic of China. captain9858@vip.sina.com. 6. China National Clinical Research Center For Neurological Diseases, Beijing, 100050, People's Republic of China. captain9858@vip.sina.com. 7. Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100050, People's Republic of China. captain9858@vip.sina.com. 8. Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, 100050, People's Republic of China. captain9858@vip.sina.com.
Abstract
PURPOSE: Seizure outcome after treatment for pediatric patients with arteriovenous malformations (AVMs) has been rarely described in the literature. The aim of this study was to determine the risk factors for seizure presentation in pediatric AVM patients and the predictors for seizure control following treatment. METHODS: We searched our characteristics of seizures associated with brain arteriovenous malformations prospectively maintained AVM database at Beijing Tiantan Hospital and identified 198 pediatric patients with brain AVMs between the year 2009 and 2014. Seizure presentation, patient characteristics, AVM features, treatment modalities, and postoperative outcomes, especially post-treatment seizure control were collected. Univariate and multivariate logistic regression analyses were applied to determine the risk factors for seizure presentation as well as the predictors for seizure control. RESULTS: Before initiation of any treatments, 63 (31.8 %) of the overall 198 patients presented with seizure. According to multivariate analyses, larger AVM size, frontal AVM location, and history of prior hemorrhage were significantly associated with seizure presentation (all p < 0.05). For patients with pre-treatment seizure presentation, good seizure outcome was achieved in 73.8 %. AVM obliteration, short-period history of seizure, and short duration for seizure onset were independent predictors of good seizure outcome in the multivariate analysis. For the 135 patients without seizures at presentation, the overall rate of de novo seizures was 4.4 %. CONCLUSION: In pediatric patients with brain AVMs, prior hemorrhage, larger AVM size, and frontal lobe location may predict subsequent seizures. Highest seizure control can be achieved by complete obliteration of the AVMs with microsurgical resection.
PURPOSE:Seizure outcome after treatment for pediatric patients with arteriovenous malformations (AVMs) has been rarely described in the literature. The aim of this study was to determine the risk factors for seizure presentation in pediatric AVM patients and the predictors for seizure control following treatment. METHODS: We searched our characteristics of seizures associated with brain arteriovenous malformations prospectively maintained AVM database at Beijing Tiantan Hospital and identified 198 pediatric patients with brain AVMs between the year 2009 and 2014. Seizure presentation, patient characteristics, AVM features, treatment modalities, and postoperative outcomes, especially post-treatment seizure control were collected. Univariate and multivariate logistic regression analyses were applied to determine the risk factors for seizure presentation as well as the predictors for seizure control. RESULTS: Before initiation of any treatments, 63 (31.8 %) of the overall 198 patients presented with seizure. According to multivariate analyses, larger AVM size, frontal AVM location, and history of prior hemorrhage were significantly associated with seizure presentation (all p < 0.05). For patients with pre-treatment seizure presentation, good seizure outcome was achieved in 73.8 %. AVM obliteration, short-period history of seizure, and short duration for seizure onset were independent predictors of good seizure outcome in the multivariate analysis. For the 135 patients without seizures at presentation, the overall rate of de novo seizures was 4.4 %. CONCLUSION: In pediatric patients with brain AVMs, prior hemorrhage, larger AVM size, and frontal lobe location may predict subsequent seizures. Highest seizure control can be achieved by complete obliteration of the AVMs with microsurgical resection.
Entities:
Keywords:
AVM size; Good seizure control; Obliteration rate; Risk factors
Authors: Christian Dorfer; Thomas Czech; Gerhard Bavinzski; Klaus Kitz; Aygül Mert; Engelbert Knosp; Andreas Gruber Journal: Childs Nerv Syst Date: 2009-11-28 Impact factor: 1.475
Authors: Robert M Starke; Ricardo J Komotar; Brian Y Hwang; Laura E Fischer; Matthew C Garrett; Marc L Otten; E Sander Connolly Journal: Br J Neurosurg Date: 2009-08 Impact factor: 1.596