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大脑动脉静脉形形是先天性的还是发育性的? 来自儿科年龄数据的证据

Sivaram S Emani¹, Ari D Kappel², Shivani D Rangwala³

¹Harvard Medical School, Boston, MA02115, USA.

Brain : a journal of neurology

|May 20, 2025

概括

儿科大脑动脉静脉形形 (AVM) 很可能发生在产后,而不是先天性. 动脉动脉瘤破裂的风险在13岁左右达到顶峰,然后降至成人水平.

科学领域:

神经学神经学
儿科神经外科儿科神经外科
血管形症血管形症

背景情况:

儿科大脑动脉静脉形形 (AVM) 的起源和自然史尚不清楚.
关键的不确定性包括AVM是先天的还是产后发展的以及与之相关的破裂风险.

研究的目的:

分析儿科大脑AVM的与年龄相关的呈现模式.
为了调查儿科AVMs的起源 (先天与产后) 和破裂风险.
开发和比较解释AVM自然历史的数学模型.

主要方法:

对275例儿科AVM病例 (2009-2022) 的回顾性审查.
分析放射学,手术和医院记录,以确定第一次出血时的年龄和AVM的特征.
开发了两个数学模型:先天性与年龄相关的破裂风险和产后性与年龄相关的发病率和恒定的破裂率.

主要成果:

流血呈现在7-14岁之间达到顶峰,随后急剧下降,即使在正常化到机构率后.
一个具有年龄相关破裂风险的先天性模型部分符合数据.
一个产后模型过度预测了青少年出血,并且无法解释观察到的衰退;然而,随着年龄的增长,无症状的AVM增加表明纯粹的先天性起源不太可能.

结论:

儿科大脑AVM很可能是在产后获得的,可能是在生命的很早.
破裂的年度风险随年龄而变,在13岁时达到顶峰,然后下降到成年人水平.

关键词:

在AVM流行病学.脑血管疾病脑血管疾病血管形血管形血管形

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