{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T19:51:40Z","timestamp":1793821900912,"version":"4.6.1"},"reference-count":84,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Epileptic seizures in patients with brain arteriovenous malformations (bAVMs) may be caused by hemodynamic alterations due to the complex angioarchitecture of bAVMs. In particular, an arterial steal phenomenon and venous outflow disruption may play an etiological role in seizure development but remain challenging to demonstrate quantitatively. Blood oxygenation level\u2013dependent (BOLD) cerebrovascular reactivity (CVR) imaging is an emerging technique that can measure both arterial steal phenomenon (as a paradoxical BOLD signal decrease during a vasodilatory stimulus) and impaired perinidal BOLD-CVR (which has been found in the presence of venous congestion on conventional angiography in bAVM patients with epilepsy). By applying this innovative BOLD-CVR technique, the aim is to better study CVR patterns and their correlation with morphological features on conventional angiography in patients with bAVM with and without epilepsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Twenty-two patients with unruptured and previously untreated bAVMs (8 with and 14 without epilepsy) were included in this case-control study. Quantitative CVR measurements were derived from BOLD functional MRI volumes using a novel standardized and precise hypercapnic stimulus (i.e., % BOLD\/mm Hg CO\n                      <jats:sub>2<\/jats:sub>\n                      ). In addition, 22 matched healthy controls underwent an identical BOLD-CVR study. Evaluation of venous congestion was performed on conventional angiography for all patients with bAVM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Patients with bAVM-associated epilepsy showed impaired whole-brain BOLD-CVR compared to those in the nonepilepsy group, even after correction for AVM volume and AVM grade (epilepsy vs nonepilepsy group: 0.17 \u00b1 0.07 vs 0.25 \u00b1 0.07, p = 0.04). A BOLD-CVR\u2013derived arterial steal phenomenon was observed in 2 patients with epilepsy (25%). Venous congestion was noted in 3 patients with epilepsy (38%) and in 1 patient without epilepsy (7%; p = 0.08).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>These data suggest that whole-brain CVR impairment, and more pronounced hemodynamic alterations (i.e., arterial steal phenomenon and venous outflow restriction), may be more present in patients with bAVM-associated epilepsy. The association of impaired BOLD-CVR and bAVM-associated epilepsy will need further investigation in a larger patient cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2022.4.focus22117","type":"journal-article","created":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T07:36:45Z","timestamp":1656661005000},"page":"E4","source":"Crossref","is-referenced-by-count":10,"title":["More pronounced hemodynamic alterations in patients with brain arteriovenous malformation\u2013associated epilepsy"],"prefix":"10.3171","volume":"53","author":[{"given":"Martina","family":"Seb\u00f6k","sequence":"first","affiliation":[{"name":"Department of Neurosurgery,"},{"name":"Clinical Neuroscience Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menno Robbert","family":"Germans","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"},{"name":"Clinical Neuroscience Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiaan Hendrik Bas van","family":"Niftrik","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"},{"name":"Clinical Neuroscience Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsolt","family":"Kulcs\u00e1r","sequence":"additional","affiliation":[{"name":"Clinical Neuroscience Center, and"},{"name":"Department of Neuroradiology, University Hospital Zurich, University of Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Regli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"},{"name":"Clinical Neuroscience Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorn","family":"Fierstra","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"},{"name":"Clinical Neuroscience Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"AJNR Am J Neuroradiol","first-page":"345","article-title":"Epilepsy associated with cerebral arteriovenous malformations: a multivariate analysis of angioarchitectural characteristics","volume":"16","author":"Turjman F","year":"1995","unstructured":"Turjman F, Massoud TF, Sayre JW, Vi\u00f1uela F, Guglielmi G, Duckwiler G. 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