• Benjamin N Africk, Daniel M Heiferman, Amy W Wozniak, Faraz Behzadi, Matthew S Ballard, Joshua M Chazaro, Brandon M Zsigray, Rachyl M Shanker, Matthew R Reynolds, Douglas E Anderson, and Joseph C Serrone.
• Department of Pediatric Neurology, Lucile Packard Children's Hospital at Stanford, 725 Welch Road, CA, 94304, Palo Alto, USA.
• J Headache Pain. 2021 Oct 9; 22 (1): 122.

BackgroundBrain arteriovenous malformations (AVMs) consist of abnormal connections between arteries and veins via an interposing nidus. While hemorrhage is the most common presentation, unruptured AVMs can present with headaches, seizures, neurological deficits, or be found incidentally. It remains unclear as to what AVM characteristics contribute to pain generation amongst unruptured AVM patients with headaches.MethodsTo assess this relationship, the current study evaluates angiographic and clinical features amongst patients with unruptured brain AVMs presenting with headache. Loyola University Medical Center medical records were queried for diagnostic codes corresponding to AVMs. In patients with unruptured AVMs, we analyzed the correlation between the presenting symptom of headache and various demographic and angiographic features.ResultsOf the 144 AVMs treated at our institution between 1980 and 2017, 76 were unruptured and had sufficient clinical data available. Twenty-three presented with headaches, while 53 patients had other presenting symptoms. Patients presenting with headache were less likely to have venous stenosis compared to those with a non-headache presentation (13 % vs. 36 %, p = 0.044).ConclusionsOur study suggests that the absence of venous stenosis may contribute to headache symptomatology. This serves as a basis for further study of correlations between AVM angioarchitecture and symptomatology to direct headache management in AVM patients.© 2021. The Author(s).

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