Early regrowth of juvenile cerebral arteriovenous malformations: report of 3 cases and immunohistochemical analysis

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• 作者：Yasushi Takagi ; MD ; PhD^a ; ^{ytakagi@kuhp.kyoto-u.ac.jp} ; Ken-ichiro Kikuta ; MD ; PhD^a ; ^b ; Kazuhiko Nozaki ; MD ; PhD^a ; ^c ; Nobuo Hashimoto ; MD ; PhD^a ; ^d
• 关键词：A-V ; arteriovenous ; AVM ; arteriovenous malformation ; IgG ; immunoglobulin G ; PBS ; phosphate-buffered saline ; PCNA ; proliferating cell nuclear antigen ; PECAM ; platelet endothelial cell adhesion molecule ; pERK ; phosphorylated extracellular signal&ndash ; regul
• 刊名：World Neurosurgery
• 出版年：2010
• 出版时间：February 2010
• 年：2010
• 卷：73
• 期：2
• 页码：100-107
• 全文大小：1786 K

文摘

Background

Regrowth of cerebral AVMs after angiographically documented obliteration has been observed in children. In addition, AVMs in adults are reported to be at risk of regrowth despite an angiogram confirming complete removal. However, the mechanism by which regrowth occurs has not been clarified; neither is it clear when regrowth occurs after removal.

Case Description

We report 3 cases showing regrowth of AVMs on postoperative angiogram performed 3 months after surgery. We also analyzed the protein levels of various factors that may influence AVM regrowth. Using immunohistochemistry, we analyzed the protein levels of the following factors: CD31 (PECAM), CD34, and CD105 (endoglin), which are endothelial or endothelial progenitor markers; VEGF, a growth factor that may influence AVM regrowth; and PCNA, a marker of proliferating cells. In addition, we analyzed the level of pERK.

Conclusion

We report 3 cases of early regrowth of cerebral AVMs. In recurrent AVM samples obtained at second operations, increased levels of perivascular CD105 and pERK immunoreactivity were seen.