LAUSR

Purpose To search for the risk factors closely related to cerebral cavernous malformation associated with developmental venous anomaly (CCM-DVA) lesions rupture, laying foundations for the development of reasonable individual treatment plans for patients. Methods In this retrospective study, we collected CCM-DVA patients who met the inclusion criteria in our outpatient department from 2014 to 2017, MRI scans were performed including susceptibility-weighted imaging (SWI) and contrast-enhanced imaging, characteristics and basic clinical information were collected then statistically analyzed, CCM-DVA lesions were divided into 3 types according to the location and quantitative relationship between CCM and DVA. Results A total number of 319 adult patients were identified with 41.2±11.9 years on average, though univariate and multivariate regression analysis, ruptured presentations were more common in patients with prior hemorrhage ( p =0.003), type III CCM-DVA lesions ( p =0.001), lesions volume>1 cm 3 ( p <0.001), infratentorial lesions especially located in midbrain ( p =0.019), pontine ( p =0.007), medulla ( p =0.015). Caplan-Meier curve shows a lower Hemorrhage-free survival rate on patients with type III CCM-DVA lesions (log-rank, p =0.0222), functional area lesions (log-rank, p <0.001), lesions volume>1 cm 3 (log-rank, p <0.001), infratentorial lesions (log-rank, p =0.0002). Conclusion The classification based on the relationship between CCM and DVA may be meaningful to predict the risk of lesion rupture and CCM lesions next to DVA distal branches showed a higher risk of rupture.