vascular-dementia-2018-scientifictracks-abstracts

5 / 16

Page 31
Notes:
conferenceseries.com
10th International Conference on
February 22-23, 2018 | Paris, France
Vascular Dementia
Volume 8 Journal of Alzheimers Disease & Parkinsonism
ISSN: 2161-0460 Vascular Dementia 2018
February 22-23, 2018
Cerebral arteriovenous malformations, hemodynamics, risk of hemorrhage and its relationship with dementia
Felipe Padilla Vazquez
Instituto Nacional de Neurología y Neurocirugía, Mexico
Background & Aim: Cerebral arteriovenous malformations (AVM) are hemodynamic lesions which must be studied as such, to
determine the cerebral blood flow, average velocity, the Reynolds number to determine turbulent or laminar flows, to calculate in
each one their risk of hemorrhage and their anatomical characteristics in this way make therapeutic decisions. In some lesions with
venous hypertension or fistulous nests, they generate a high degree of hyper flow, which can cause perilesional vasculopathy to the
AVMs nidus, areas of hypoperfusion that can generate dementia.
Method: We did a retrospective study that included 639 patients with ruptured and un-ruptured AVMs. We proposed a new
classification score (1-4 points) for AVM rupture risk using three factors; feeding artery mean velocity (Vm), nidus size and type
of venous drainage. We employed descriptive statistics and logistic regression analysis. We analyzed the different type of nidus in
each AVM (plexiform, mixto and fistulous), angiopathy data were determined by recruitment in some lesions and their perinidal
repercussion. The patient´s clinic was determined as well as the study of superior mental functions with a mini-mental test.
Results: A total of 639 patients with cerebral AVMs, 388 (60%) had un-ruptured AVMs and 251 (40%) had ruptured AVMs.
Logistic regression analysis revealed a significant effect of Vm (mean velocity), nidus size and venous drainage type in accounting
for the variability of rupture odds (P=0.0001, R2=0.437), for patients with AVMs. Based in the odds ratios, grades 1 and 2 of the
proposed classification were corresponded to low risk of hemorrhage, while grades 3 and 4 were associated with hemorrhage: 1
point OR=0.10795% CI; 0.061-0.188, 2 point OR=0.227 95%, CI; 0.153-0.338, 3 point OR=3.292 95%, CI; 2.325-4.661, and 4 point
OR=23.304 95%, CI; 11.077-49.027. We catalog different types of venous drainage, type 1, the anterograde (downstream or normal
flow); type 2 the retrograde (upstream or reverse flow) and type 3, retrograde (upstream or reverse flow)+facial venous drainage. We
observed that patients who had retrograde flow associated with large AVMs with a fistulous nidus were those that presented dementia
data.
Conclusion: This classification is useful and easy to use, and it may allow for the individualization of each cerebral AVM and the
assessment of rupture risk based on a model of categorization. The retrograde flow and the fistulous nidus of the AVMs have a high
risk of dementia.
Biography
Felipe Padilla Vazquez is a specialist in neurointervention, neuropathic endovascular therapy, cerebrovascular diseases, column surgery, CNS oncological surgery,
headaches, neuropathic pain and presently he is a Member of the Mexican Society of Neurological Surgery AC.
Felipe Padilla Vazquez, J Alzheimers Dis Parkinsonism 2018, Volume 8
DOI: 10.4172/2161-0460-C1-036