EPILEPSY ASSOCIATED WITH CEREBRAL ARTERIOVENOUS-MALFORMATIONS - A MULTIVARIATE-ANALYSIS OF ANGIOARCHITECTURAL CHARACTERISTICS

PURPOSE: To identify the morphological vascular characteristics of cer ebral arteriovenous malformations (AVMs) that predict a clinical prese ntation of epilepsy. METHOD: Fifteen angioarchitectural characteristic s of brain AVMs were selected for assessment in 100 consecutive patien ts referred to our institution for endovascular treatment. In this pop ulation, 47% of the AVMs were diagnosed as a consequence of epilepsy. The angioarchitectural characteristics and population demographics wer e statistically analyzed by means of multivariate analysis. RESULTS: T he following six parameters were found to be the most predictive of ep ilepsy: cortical location of the AVM, feeding by the middle cerebral a rtery, cortical location of the feeder, absence of aneurysms, presence of varix/varices in the venous drainage, and association of varix and absence of intranidal aneurysms. Three factors were not among the mos t predictive factors of epilepsy but were significantly associated wit h the onset of seizures: AVM feeding by the external carotid artery, a temporal cortical location, and a parietal cortical location. CONCLUS ION: Detailed analysis of the angioarchitecture of intracranial AVMs h as helped us identify features that strongly correlate with epilepsy. This may aid in future understanding of the physiopathologic mechanism s in epilepsy associated with AVMs, and in identifying goals of treatm ent for epileptogenic AVMs.