{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T19:51:03Z","timestamp":1793821863354,"version":"4.6.1"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1999,4]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> The authors sought to establish prospectively whether there is a simple relationship between radiological features of brain arteriovenous malformation (AVM) hemodynamics and a patient's clinical presentation.<\/jats:p><jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> Thirty-one consecutive patients with AVMs underwent cerebral angiography at 3.8 frames\/second during each standardized injection of contrast material. Contrast dilution curves were derived from the image sequences by using regions of interest (ROIs) traced on arteries feeding and veins draining the AVM nidus. Angiographic parameters were then analyzed in a blinded fashion. These parameters included the times required to reach the peak contrast density, the contrast decay time, and fractions thereof, in the ROI for each vessel. The authors determined whether these parameters, the arteriovenous transit time, and\/or AVM size were related to patients' presentation with hemorrhage (11 patients), seizure (11 patients), or other clinical symptoms (nine patients). Statistically significant results were found only in analyses of arterial phase times to reach peak contrast density. Analyses of venous parameters, AVM size, and nidus transit time showed trends but no statistical significance. Arterial filling with contrast material was significantly slower in patients presenting with hemorrhage (mean 50%, 80%, and 100% of time to peak \u00b1 standard error [SE] = 1.19 \u00b1 0.13, 1.97 \u00b1 0.18, and 3.04 \u00b1 0.34 seconds, respectively) compared with patients presenting with seizures (mean 50%, 80%, and 100% of time to peak \u00b1 SE = 0.80 \u00b1 0.12, 1.32 \u00b1 0.18, and 1.95 \u00b1 0.29 seconds, respectively) according to analysis of variance (p &lt; 0.05) and post-hoc t-tests (p &lt; 0.05) for each parameter. Patients who presented with other symptoms had intermediate arterial filling times.<\/jats:p><jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> These simple hemodynamic parameters, which can be obtained without added risk to the patient, may help identify a subset of individuals in whom AVMs pose a higher risk of future hemorrhage and who may therefore warrant more expeditious treatment.<\/jats:p>","DOI":"10.3171\/jns.1999.90.4.0673","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:20:04Z","timestamp":1242235204000},"page":"673-679","source":"Crossref","is-referenced-by-count":64,"title":["A simple relationship between radiological arteriovenous malformation hemodynamics and clinical presentation: a prospective, blinded analysis of 31 cases"],"prefix":"10.3171","volume":"90","author":[{"given":"John S.","family":"Norris","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taufik A.","family":"Valiante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Christopher","family":"Wallace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Willinsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter J.","family":"Montanera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karel G.","family":"terBrugge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Tymianski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Cerebrovascular Disease.","first-page":"833","article-title":"Intracranial arteriovenous malformations: cerebrovascular hemodynamics","author":"Brown","year":"1997"},{"key":"b2","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"859","DOI":"10.3171\/jns.1990.73.6.0859","article-title":"Unruptured intracranial aneurysms and arteriovenous malformations: frequency of intracranial hemorrhage and relationship of lesions.","volume":"73","author":"Brown","year":"1990"},{"key":"b3","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"352","DOI":"10.3171\/jns.1988.68.3.0352","article-title":"The natural history of unruptured intracranial arteriovenous malformations.","volume":"68","author":"Brown","year":"1988"},{"key":"b4","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/jnnp.49.1.1","article-title":"Arteriovenous malformations of the brain: natural history in unoperated patients.","volume":"49","author":"Crawford","year":"1986"},{"key":"b5","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1161\/01.STR.12.3.273","article-title":"Management of cerebral aneurysm.","volume":"12","author":"Drake","year":"1981"},{"key":"b6","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"331","DOI":"10.3171\/jns.1983.58.3.0331","article-title":"Bleeding from cerebral arteriovenous malformations as part of their natural history.","volume":"58","author":"Graf","year":"1983"},{"key":"b7","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1097\/00006123-199605000-00030","article-title":"A biomathematical model of intracranial arteriovenous malformations based on electrical network analysis: theory and hemodynamics.","volume":"38","author":"Hademenos","year":"1996"},{"key":"b8","series-title":"Neurosurgery","first-page":"801","article-title":"The influence of hemodynamic and anatomic factors on hemorrhage from cerebral arteriovenous malformations.","volume":"34","author":"Kader","year":"1994"},{"key":"b9","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"630","DOI":"10.3171\/jns.1961.18.5.0630","article-title":"Vascular malformations of the brain. An anatomical study.","volume":"18","author":"Kaplan","year":"1961"},{"key":"b10","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"219","DOI":"10.3171\/jns.1966.25.2.0219","article-title":"Report on the Cooperative Study of Intracranial Aneusysms and Subarachnoid Hemorrhage. Section V, Part I. Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. Based on 6368 cases in the cooperative study.","volume":"25","author":"Locksley","year":"1966"},{"key":"b11","series-title":"Intracranial Arteriovenous Malformations.","first-page":"12","article-title":"Natural history of cerebral arteriovenous malformations","author":"Luessenhop","year":"1984"},{"key":"b12","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1148\/radiology.176.3.2389040","article-title":"Hemorrhage in intracerebral arteriovenous malformations: angiographic determinants.","volume":"176","author":"Marks","year":"1990"},{"key":"b13","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1161\/01.STR.25.2.504","article-title":"Draining vein pressure increases and hemorrhage in patients with arteriovenous malformation.","volume":"25","author":"Miyasaka","year":"1994"},{"key":"b14","series-title":"Intracranial Arteriovenous Malformations.","first-page":"1","article-title":"Neurological manifestations and factors related to therapeutic decisions","author":"Mohr","year":"1984"},{"key":"b15","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"387","DOI":"10.3171\/jns.1990.73.3.0387","article-title":"The natural history of symptomatic arteriovenous malformations of the brain: a 24year follow-up assessment.","volume":"73","author":"Ondra","year":"1990"},{"key":"b16","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1227\/00006123-199103000-00006","article-title":"The relevance of anatomic and hemodynamic factors to a classification of cerebral arteriovenous malformations.","volume":"28","author":"Pasqualin","year":"1991"},{"key":"b17","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"467","DOI":"10.3171\/jns.1966.25.4.0467","article-title":"Report on the Cooperative Study of Intracranial Aneusysms and Subarachnoid Hemorrhage. Section VI. Arteriovenous malformations. An analysis of 545 cases of cranio-cerebral malformations and fistulae reported to the cooperative study.","volume":"25","author":"Perret","year":"1966"},{"key":"b18","series-title":"Neurosurgery Update II: Vascular, Spinal, Pediatric, and Functional Neurosurgery.","first-page":"129","article-title":"Preoperative evaluation of the risk\/benefit ratio for arteriovenous malformations of the brain","author":"Samson","year":"1991"},{"key":"b19","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"918","DOI":"10.3171\/jns.1992.76.6.0918","article-title":"Relationship of perfusion pressure and size to risk of hemorrhage from arteriovenous malformations.","volume":"76","author":"Spetzler","year":"1992"},{"key":"b20","series-title":"AJNR","first-page":"1303","article-title":"Evaluation of intraaneurysmal blood velocity by time-density curve analysis and digital subtraction angiography.","volume":"19","author":"Tenjin","year":"1998"},{"key":"b21","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1227\/00006123-199409000-00005","article-title":"Arteriovenous malformation draining vein physiology and determinants of transnidal pressure gradients.","volume":"35","author":"Young","year":"1994"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/90\/4\/article-p673.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/90\/4\/article-p673.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/90\/4\/article-p673.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,13]],"date-time":"2022-11-13T02:41:20Z","timestamp":1668307280000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/90\/4\/article-p673.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,4]]},"references-count":21,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/jns.1999.90.4.0673","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1999,4]]}}}