Demographic and angioarchitectural features associated with seizures presentation in patients with brain arteriovenous malformations in Durban, KwaZulu-Natal, South Africa
Background: Brain arteriovenous malformations (AVMs) often present with epileptic seizures which carry standard mortality rate two to three folds higher than in the general population, yet preventative eradication of these lesions remains controversial. The aim of this study was to determine the dem...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-03-01
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| Series: | Interdisciplinary Neurosurgery |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751917301627 |
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| author | Mogwale Samson Motebejane, MBChB, Mmed Neurosurg (UKZN), FC Neurosurg (SA) Duncan Royston, MBChB, FFRad, MSc Gaëtan Kabera, PhD Rohen Harrichandparsad, MBChB, FC Neurosurg (SA), Mmed Neurosurg Ian Kaminsky, MD In Sup Choi, MD, FARC |
| author_facet | Mogwale Samson Motebejane, MBChB, Mmed Neurosurg (UKZN), FC Neurosurg (SA) Duncan Royston, MBChB, FFRad, MSc Gaëtan Kabera, PhD Rohen Harrichandparsad, MBChB, FC Neurosurg (SA), Mmed Neurosurg Ian Kaminsky, MD In Sup Choi, MD, FARC |
| author_sort | Mogwale Samson Motebejane, MBChB, Mmed Neurosurg (UKZN), FC Neurosurg (SA) |
| collection | DOAJ |
| description | Background: Brain arteriovenous malformations (AVMs) often present with epileptic seizures which carry standard mortality rate two to three folds higher than in the general population, yet preventative eradication of these lesions remains controversial. The aim of this study was to determine the demographic and angioarchitectural features associated with clinical presentation of seizures in patients with brain AVMs. Methods: We conducted a retrospective chart review of all consecutive patients who presented to three interventional neuroradiology hospitals, with brain AVMs in Kwazulu-Natal, South Africa, over a period of 10years. The demographic and clinical presentations were derived from patient's electronic medical records. Radiological features were determined using axial Computerized Topography (CT) or Magnetic Resonance Imaging (MRI) Scan. Angioarchitectural features were determined from Digital Subtraction Angiography (DSA). Simple and multiple logistic regression models were used to identify factors associated with the risk of seizure as initial presentation in brain AVMs. Results: The analysis identified race/ethnicity, nidus size and location as the predictors of seizure presentation. By multiple logistic regression analysis, African-black race (OR=4.7; 95%CI: 1.15–19.60), brain AVM nidus >3cm in diameter, (OR=4.4; 95%CI: 1.7−11.42) and cortical lobar location (OR=13.6; 95%CI: 2.80−65.14) were found to be significant predictors of brain AVM-associated seizures. Conclusion: Improved knowledge of specific morphological factors associated with brain AVM epilepsy could aid in the formulation of appropriate therapeutic strategies for control and/or cure of these brain AVM-associated seizures. Keywords: Angioarchitecture, Arteriovenous malformations, Brain, Demographics, Seizures |
| first_indexed | 2024-04-12T01:15:08Z |
| format | Article |
| id | doaj.art-1beefad7e61e4beaa074bfa14ed3a07e |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-04-12T01:15:08Z |
| publishDate | 2018-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-1beefad7e61e4beaa074bfa14ed3a07e2022-12-22T03:53:58ZengElsevierInterdisciplinary Neurosurgery2214-75192018-03-01111418Demographic and angioarchitectural features associated with seizures presentation in patients with brain arteriovenous malformations in Durban, KwaZulu-Natal, South AfricaMogwale Samson Motebejane, MBChB, Mmed Neurosurg (UKZN), FC Neurosurg (SA)0Duncan Royston, MBChB, FFRad, MSc1Gaëtan Kabera, PhD2Rohen Harrichandparsad, MBChB, FC Neurosurg (SA), Mmed Neurosurg3Ian Kaminsky, MD4In Sup Choi, MD, FARC5Department of Neurosurgery, Inkosi Albert Luthuli Central Hospital, 800 Vusi Mzimela Road, Cato-Manor, Durban 4091, South Africa; Nelson R Mandela School of Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Corresponding author at: 36 Celtis Road, Marianhill-park, and Pinetown, KwaZulu-Natal, South Africa.Nelson R Mandela School of Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Department of Interventional Neuroradiology, Entabeni Private Hospital, Durban, South AfricaDepartment of Statistics, University of South Africa, 392 UNISA, Johannesburg 0003, South AfricaDepartment of Neurosurgery, Inkosi Albert Luthuli Central Hospital, 800 Vusi Mzimela Road, Cato-Manor, Durban 4091, South Africa; Nelson R Mandela School of Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South AfricaDepartment of Interventional Neuroradiology, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, Boston 01806, United StatesDepartment of Interventional Neuroradiology, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, Boston 01806, United StatesBackground: Brain arteriovenous malformations (AVMs) often present with epileptic seizures which carry standard mortality rate two to three folds higher than in the general population, yet preventative eradication of these lesions remains controversial. The aim of this study was to determine the demographic and angioarchitectural features associated with clinical presentation of seizures in patients with brain AVMs. Methods: We conducted a retrospective chart review of all consecutive patients who presented to three interventional neuroradiology hospitals, with brain AVMs in Kwazulu-Natal, South Africa, over a period of 10years. The demographic and clinical presentations were derived from patient's electronic medical records. Radiological features were determined using axial Computerized Topography (CT) or Magnetic Resonance Imaging (MRI) Scan. Angioarchitectural features were determined from Digital Subtraction Angiography (DSA). Simple and multiple logistic regression models were used to identify factors associated with the risk of seizure as initial presentation in brain AVMs. Results: The analysis identified race/ethnicity, nidus size and location as the predictors of seizure presentation. By multiple logistic regression analysis, African-black race (OR=4.7; 95%CI: 1.15–19.60), brain AVM nidus >3cm in diameter, (OR=4.4; 95%CI: 1.7−11.42) and cortical lobar location (OR=13.6; 95%CI: 2.80−65.14) were found to be significant predictors of brain AVM-associated seizures. Conclusion: Improved knowledge of specific morphological factors associated with brain AVM epilepsy could aid in the formulation of appropriate therapeutic strategies for control and/or cure of these brain AVM-associated seizures. Keywords: Angioarchitecture, Arteriovenous malformations, Brain, Demographics, Seizureshttp://www.sciencedirect.com/science/article/pii/S2214751917301627 |
| spellingShingle | Mogwale Samson Motebejane, MBChB, Mmed Neurosurg (UKZN), FC Neurosurg (SA) Duncan Royston, MBChB, FFRad, MSc Gaëtan Kabera, PhD Rohen Harrichandparsad, MBChB, FC Neurosurg (SA), Mmed Neurosurg Ian Kaminsky, MD In Sup Choi, MD, FARC Demographic and angioarchitectural features associated with seizures presentation in patients with brain arteriovenous malformations in Durban, KwaZulu-Natal, South Africa Interdisciplinary Neurosurgery |
| title | Demographic and angioarchitectural features associated with seizures presentation in patients with brain arteriovenous malformations in Durban, KwaZulu-Natal, South Africa |
| title_full | Demographic and angioarchitectural features associated with seizures presentation in patients with brain arteriovenous malformations in Durban, KwaZulu-Natal, South Africa |
| title_fullStr | Demographic and angioarchitectural features associated with seizures presentation in patients with brain arteriovenous malformations in Durban, KwaZulu-Natal, South Africa |
| title_full_unstemmed | Demographic and angioarchitectural features associated with seizures presentation in patients with brain arteriovenous malformations in Durban, KwaZulu-Natal, South Africa |
| title_short | Demographic and angioarchitectural features associated with seizures presentation in patients with brain arteriovenous malformations in Durban, KwaZulu-Natal, South Africa |
| title_sort | demographic and angioarchitectural features associated with seizures presentation in patients with brain arteriovenous malformations in durban kwazulu natal south africa |
| url | http://www.sciencedirect.com/science/article/pii/S2214751917301627 |
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