Analysis of the type of course of arteriovenous malformations of the brain on the basis of the evaluation of the personalized features of angioarchitectonics of venous drainages

Abstract

Background. Arteriovenous malformations of the brain are a rare congenital vascular pathology. At the moment, the study of the venous component of arteriovenous malformations is a hot topic of many studies. Most authors believe that the angioarchitectural features of the venous link of arteriovenous malformations can have a significant impact on assessing the natural course of the pathology and determining the tactics of treating these patients. Objective. In our work, we conducted a assessment and compared the personalized features of venous drainage of arteriovenous malformations of the brain with the type of clinical course. Design and methods. We analyzed the results of a survey of 61 adult patients with arteriovenous malformations of the brain, observed in the neurosurgical department No. 3 of the RNSI n. a. prof. A. L. Polenov in the period from 2014 to 2021. Gender and age characteristics and neuroimaging data, as well as features of the venous outflow of arteriovenous malformations were analyzed. Groups of patients were composed according to the type of the course of the disease and a personalized analysis was carried out with the characteristics of the venous outflow, as well as their features. The male/female ratio was 1.5/1 (37/24). Patients under 45 years of age prevailed (77.1 %). By types of clinical course: hemorrhagic type — 18 cases (29.5 %); epileptic type — 24 patients (39.3 %); torpid type — 19 patients (31.2 %). Results. A correlation was found between the deep location of the body of the malformation, as well as drainage exclusively into the deep vein system, and the hemorrhagic type of course (p = 0.034), while the male gender and superficial localization of the malformation were more characteristic of the epileptic type (p = 0.01). The torpid flow type did not have significant relationships with the studied features. Conclusion. According to our data, an analysis of the personalized characteristics of venous drainage of cerebral arteriovenous malformations can help in assessing the clinical course, which will improve the treatment outcomes of these patients.