Pure arterial malformations of the brain: A systematic review of clinical presentation, diagnosis, and management.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

Neuroradiology Pub Date : 2025-08-01 Epub Date: 2025-06-03 DOI:10.1007/s00234-025-03665-3

Milin Patel, Sahibjot Singh Grewal, Rashid A Ahmed, James D Rabinov, Robert W Regenhardt, Adam A Dmytriw

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引用次数: 0

Abstract

Background: Pure arterial malformations (PAMs) of the brain are rare vascular anomalies, typically identified incidentally and characterized by tortuous arterial loops. Their unclear etiology and management pose diagnostic and therapeutic challenges.

Methods: A systematic review of Medline, EMBASE, and Web of Science databases (1900-present) identified 15 studies involving 54 patients with PAM. Data on demographics, clinical presentations, diagnostic modalities, and treatments were extracted.

Results: The mean age was 37.2 years (range: 10-77), with a female predominance (69%). Severe headaches were the most common symptom (43%), though some cases presented with neurological deficits (20%) or incidentally (32%). Imaging modalities such as digital subtraction angiography, MRI, and CT were pivotal in diagnosis. Most cases (81%) were managed conservatively, while 19% had interventions, including clipping and embolization. Surgical management was effective in alleviating symptoms in select cases of symptom progression.

Conclusion: Our findings highlight the variability in clinical presentations ranging from benign to acute emergencies, emphasizing the challenges associated with the diagnosis and management of PAMs. This review underscores the need for larger studies that explore the etiology, treatment efficacy, and long-term patient outcomes.

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单纯的脑动脉畸形：临床表现、诊断和治疗的系统回顾。

背景：单纯的脑动脉畸形（PAMs）是一种罕见的血管异常，通常是偶然发现的，其特征是动脉袢弯曲。病因不明，治疗困难。方法：对Medline、EMBASE和Web of Science数据库（1900年至今）进行系统回顾，确定了15项研究，涉及54例PAM患者。提取了人口统计学、临床表现、诊断方式和治疗方面的数据。结果：平均年龄37.2岁（范围：10 ~ 77岁），以女性为主（69%）。严重头痛是最常见的症状（43%），尽管一些病例表现为神经功能障碍（20%）或偶然（32%）。成像方式，如数字减影血管造影，MRI和CT是诊断的关键。大多数病例（81%）采用保守治疗，19%采用夹持和栓塞等干预措施。手术治疗在缓解症状进展的特定病例中是有效的。结论：我们的研究结果强调了临床表现的可变性，从良性到急性紧急情况，强调了与PAMs诊断和管理相关的挑战。这篇综述强调需要进行更大规模的研究来探索病因、治疗效果和患者的长期预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.