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Angioarchitectural features of brain arteriovenous malformation presented with seizures

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Abstract

Seizures are the second most common manifestations of brain arteriovenous malformations (bAVMs). This study was conducted to investigate the clinical and angioarchitectural features of bAVMs with seizures and provide guidelines for the clinical management of these patients. We collected clinical and radiological data on patients with bAVMs diagnosed by digital subtraction angiography between January 2013 and December 2020 and dichotomized the patients into the seizures and non-seizures groups. We identified differences in demographic and angiographic features. Logistic regression and random forest (RF) models were developed and compared. The diagnostic capacity was assessed using receiver operating characteristic (ROC) curves. A nomogram was constructed, and the clinical impact was determined by decision curve analysis. A total of 414 patients with bAVMs were included in the analysis, of which 78 (18.8%) had bAVM-related seizures. In the multivariable logistic regression model, the location and side of bAVMs were independently associated with seizures. In RF models, the maximal diameter of veins and the cross-sectional area of feeding arteries and draining veins were the most important features. ROC curves showed that the RF model was not better than MLR in predicting seizures. Decision curve analysis revealed that the use of a constructed nomogram to stratify the seizure patients was beneficial at all threshold probabilities in our study. The side and location of bAVMs are specific angioarchitectural features independently associated with the occurrences of seizures with bAVMs.

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Data availability

The original contributions presented in the study are included in the article/supplementary material. Further inquiries can be directed to the corresponding authors.

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Funding

This study has received funding by grants from the National Natural Science Foundation of China (Grant Number 81873756).

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Authors and Affiliations

  1. Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China

    Langchao Yan, Wengui Tao, Qian Zhan, Zheng Huang, Fenghua Chen & Shifu Li

Authors
  1. Langchao Yan
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  2. Wengui Tao
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  3. Qian Zhan
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  4. Zheng Huang
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  5. Fenghua Chen
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  6. Shifu Li
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Contributions

Langchao Yan: study concept and design, acquisition of data, statistical analysis, interpretation of data; Wengui Tao and Zheng Huang: acquisition and analysis of data; Qian Zhang: analysis and interpretation of data, critical revision of manuscript; Fenghua Chen and Shifu Li: study concept and design, study supervision.

Corresponding author

Correspondence to Shifu Li.

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All procedures in this study that involved human participants were approved by the ethics committee of our hospital and were performed in accordance with the standards of institutional ethics, the 1964 Declaration of Helsinki, and its later amendments, or comparable ethical standards.

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Informed consent was obtained from all individual participants with normal neurological status or by relatives in all other cases.

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The authors agreed this publication.

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The authors declare no competing interests.

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Yan, L., Tao, W., Zhan, Q. et al. Angioarchitectural features of brain arteriovenous malformation presented with seizures. Neurosurg Rev 45, 2909–2918 (2022). https://doi.org/10.1007/s10143-022-01814-3

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  • DOI: https://doi.org/10.1007/s10143-022-01814-3

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