Perfil epidemiológico de pacientes portadores de malformações arteriovenosas intracranianas em hospital quaternário da região metropolitana de Curitiba
Tipo
TCC
Data de publicação
2024-06-06
Periódico
Citações (Scopus)
Autores
Araújo, Laura Brito
Regis, Marjorie Maria Monteiro
Regis, Marjorie Maria Monteiro
Orientador
Bufon, Viviane Aline
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Introdução: Malformações arteriovenosas (MAVs) são lesões vasculares de alto fluxo e baixa resistência, consistindo em enovelados de vasos displásicos caracterizados por conexões anormais entre artérias e veias. A incidência das MAVs é de cerca de 1,12-1,34 a cada 100.000 pessoas por ano. A apresentação clínica das lesões é variável, no entanto, a ruptura das MAVs intracranianas é a principal causa de hemorragias intracranianas (HICs) em pacientes abaixo de 40 anos, constituindo grande fator de morbimortalidade neste grupo. Objetivos: Analisar o perfil epidemiológico de pacientes diagnosticados com MAVs, contemplando a idade, o sexo, o local da lesão, apresentação inicial e a classificação de Spetzler-Martin (SM). Metodologia: O presente trabalho consiste em um estudo observacional transversal retrospectivo realizado a partir da coleta de dados obtidos em 50 prontuários de pacientes vinculados a um Hospital quaternário localizado na região metropolitana de Curitiba. Tendo esses sido atendidos entre os anos de 2018 e 2023 e submetidos à arteriografia como método diagnóstico de MAV. A partir do diagnóstico destas lesões, os pacientes foram incluídos na amostra. A partir do Teste qui-quadrado e do teste de Mann-Whitney foram analisadas as seguintes variáveis: sexo, idade, local da lesão, classificação de Spetzler-Martin e apresentação clínica inicial. Resultados: Houve equivalência entre homens e mulheres apresentando MAV; a localização da MAV foi predominantemente em região occipitoparietal. A média das idades dos pacientes foi de 42,02 anos. Em relação à classificação de SM, a maioria dos pacientes foram classificados como portadores de MAV tipo II e nenhum dos pacientes apresentou classificação de SM tipo I. Quase metade dos pacientes tiveram a MAV localizada no hemisfério cerebral esquerdo. HIC foi a principal manifestação clínica, e o padrão de drenagem superficial foi mais comum. Não houve relevância estatística ao comparar manifestação hemorrágica com as seguintes variáveis: sexo, idade, localização hemisférica da lesão e classificação de SM. Conclusão: Dentre os pacientes analisados, o local da lesão foi predominantemente na região occipitoparietal. A classificação quanto ao risco cirúrgico das MAVs foi principalmente SM tipo II. O hemisfério cerebral esquerdo foi o mais acometido e, quanto ao padrão de drenagem venosa das malformações vasculares, a maioria dos pacientes teve o tipo superficial.
Introduction: Arteriovenous malformations (AVMs) are high-flow, low-resistance vascular lesions consisting of tangles of dysplastic vessels characterized by abnormal connections between arteries and veins. The incidence of AVMs is around 1.12-1.34 per 100,000 people per year. The clinical presentation of the lesions varies, however, ruptured intracranial AVMs are the main cause of intracranial hemorrhages (ICHs) in patients under 40 years of age, constituting a major morbidity and mortality factor in this group. Objectives: To analyze the epidemiological profile of patients diagnosed with AVMs, including age, gender, lesion site, initial presentation and Spetzler-Martin (SM) classification. Methodology: This study consists of a retrospective cross-sectional observational study based on the collection of data from 50 medical records of patients linked to a quaternary hospital located in the metropolitan region of Curitiba. These patients were seen between 2018 and 2023 and underwent arteriography as a diagnostic method for AVMs. Once these lesions were diagnosed, the patients were included in the sample. The chi-square test and Mann-Whitney test were used to analyze the following variables: gender, age, lesion site, Spetzler-Martin classification and initial clinical presentation. Results: There was an equivalence between men and women presenting with AVMs; the location of the AVM was predominantly in the occipitoparietal region. The average age of the patients was 42.02 years. Regarding the classification of SM, most of the patients were classified as having type II AVMs and none of the patients had type I SM. Almost half of the patients had AVMs located in the left cerebral hemisphere. ICH was the main clinical manifestation, and the superficial drainage pattern was more common. There was no statistical significance when comparing hemorrhagic manifestations with the following variables: gender, age, hemispheric location of the lesion and MS classification. Conclusion: Among the patients analyzed, the lesion site was predominantly in the occipitoparietal region. The surgical risk classification of AVMs was mainly type II SM. The left cerebral hemisphere was the most affected and the venous drainage pattern of the vascular malformations was mostly superficial.
Introduction: Arteriovenous malformations (AVMs) are high-flow, low-resistance vascular lesions consisting of tangles of dysplastic vessels characterized by abnormal connections between arteries and veins. The incidence of AVMs is around 1.12-1.34 per 100,000 people per year. The clinical presentation of the lesions varies, however, ruptured intracranial AVMs are the main cause of intracranial hemorrhages (ICHs) in patients under 40 years of age, constituting a major morbidity and mortality factor in this group. Objectives: To analyze the epidemiological profile of patients diagnosed with AVMs, including age, gender, lesion site, initial presentation and Spetzler-Martin (SM) classification. Methodology: This study consists of a retrospective cross-sectional observational study based on the collection of data from 50 medical records of patients linked to a quaternary hospital located in the metropolitan region of Curitiba. These patients were seen between 2018 and 2023 and underwent arteriography as a diagnostic method for AVMs. Once these lesions were diagnosed, the patients were included in the sample. The chi-square test and Mann-Whitney test were used to analyze the following variables: gender, age, lesion site, Spetzler-Martin classification and initial clinical presentation. Results: There was an equivalence between men and women presenting with AVMs; the location of the AVM was predominantly in the occipitoparietal region. The average age of the patients was 42.02 years. Regarding the classification of SM, most of the patients were classified as having type II AVMs and none of the patients had type I SM. Almost half of the patients had AVMs located in the left cerebral hemisphere. ICH was the main clinical manifestation, and the superficial drainage pattern was more common. There was no statistical significance when comparing hemorrhagic manifestations with the following variables: gender, age, hemispheric location of the lesion and MS classification. Conclusion: Among the patients analyzed, the lesion site was predominantly in the occipitoparietal region. The surgical risk classification of AVMs was mainly type II SM. The left cerebral hemisphere was the most affected and the venous drainage pattern of the vascular malformations was mostly superficial.
Descrição
Palavras-chave
epidemiologia , malformações arteriovenosas , malformações arteriovenosas intracranianas , epidemiology , arteriovenous malformations , intracranial arteriovenous malformations