• Sophia F Shakur, Denise Brunozzi, Rahim Ismail, Dilip Pandey, Fady T Charbel, and Ali Alaraj.
• Department of Neurosurgery, University of Illinois, Chicago, Illinois, USA.
• World Neurosurg. 2018 May 1; 113: e654-e658.

ObjectiveThe pathogenesis of venous intimal hyperplasia and venous outflow stenosis associated with cerebral arteriovenous malformation (AVM) draining veins is poorly understood. We sought to determine the relationship between venous stenosis and age.MethodsAll patients with an AVM seen at our institution between 1990 and 2016 who underwent a diagnostic cerebral angiogram were retrospectively reviewed. Draining vein stenosis was measured from angiograms before any treatment. The relationship between venous stenosis and age was assessed.ResultsWe included 281 patients (mean age 39 years, age range 3-83 years, 55% male). Venous stenosis measuring ≥50% was present in 59 patients (21% of cohort). Peak age at presentation was 25-29 years, whereas peak frequency of venous stenosis ≥50% was 50-54 years. Venous stenosis was present in a significantly higher proportion of patients ≥50 years versus <50 years (P = 0.03). Mean percentage stenosis was significantly higher in patients ≥50 years versus <50 years (32% vs. 22%, P = 0.001).ConclusionsClinically significant cerebral AVM draining vein stenosis appears to be associated with older age, suggesting that venous stenosis is a progressive disease that occurs by the same process that leads to intimal hyperplasia. These results should be confirmed with a population-based longitudinal study.Copyright © 2018 Elsevier Inc. All rights reserved.

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