scholarly journals Cerebral Arteriovenous Malformations with Associated Arterial Aneurysms: Hemodynamic and Therapeutic Considerations

Author(s):  
Douglas Kondziolka ◽  
Bruce J. Nixon ◽  
Pierre Lasjaunias ◽  
Pierre Lasjaunias ◽  
William S. Tucker ◽  
...  

ABSTRACT:The common vascular anomalies of cerebral aneurysm and arteriovenous malformation may exist independently, or together as part of a closely related hemodynamic pairing. Resection or embolization of an AVM may be followed by a decrease in local blood flow, and lead to regression of a suitably situated proximal aneurysm. However, aneurysms located outside the angioarchitecture of the AVM, which remain flow-unrelated to the malformation, will likely not regress, and may in fact enlarge. Two cases are presented which demonstrate these vascular relationships, in order to better understand the regional hemodynamics of these anomalies prior to surgical or endovascular treatment planning.

2015 ◽  
Vol 6 (1) ◽  
pp. 3 ◽  
Author(s):  
EladI Levy ◽  
TravisM Dumont ◽  
Peter Kan ◽  
KennethV Snyder ◽  
LNelson Hopkins ◽  
...  

2014 ◽  
Vol 35 (5) ◽  
pp. 978-983 ◽  
Author(s):  
H. Baharvahdat ◽  
R. Blanc ◽  
R. Termechi ◽  
S. Pistocchi ◽  
B. Bartolini ◽  
...  

2013 ◽  
Vol 11 (5) ◽  
pp. 547-551 ◽  
Author(s):  
Fabio A. Frisoli ◽  
Shih-Shan Lang ◽  
Arastoo Vossough ◽  
Anne Marie Cahill ◽  
Gregory G. Heuer ◽  
...  

Object Cerebral arteriovenous malformations (AVMs) have a higher postresection recurrence rate in children than in adults. The authors' previous study demonstrated that a diffuse AVM (low compactness score) predicts postresection recurrence. The aims of this study were to evaluate the intra- and interrater reliability of the AVM compactness score. Methods Angiograms of 24 patients assigned a preoperative compactness score (scale of 1–3; 1 = most diffuse, 3 = most compact) in the authors' previous study were rerated by the same pediatric neuroradiologist 9 months later. A pediatric neurosurgeon, pediatric neuroradiology fellow, and interventional radiologist blinded to each other's ratings, the original ratings, and AVM recurrence also rated each AVM's compactness. Intrarater and interrater reliability were calculated using the κ statistic. Results Of the 24 AVMs, scores by the original neuroradiologist were 1 in 6 patients, 2 in 16 patients, and 3 in 2 patients. Intrarater reliability was 1.0. The κ statistic among the 4 raters was 0.69 (95% CI 0.44–0.89), which indicates substantial reliability. The interrater reliability between the neuroradiologist and neuroradiology fellow was moderate (κ = 0.59 [95%CI 0.20–0.89]) and was substantial between the neuroradiologist and neurosurgeon (κ = 0.74 [95% CI 0.41–1.0]). The neuroradiologist and interventional radiologist had perfect agreement (κ = 1.0). Conclusions Intrarater and interrater reliability of the AVM compactness score were excellent and substantial, respectively. These results demonstrate that the AVM compactness score is reproducible. However, the neuroradiologist and interventional radiologist had perfect agreement, which indicates that the compactness score is applied most accurately by those with extensive angiography experience.


2013 ◽  
Vol 19 (1) ◽  
pp. 27-34 ◽  
Author(s):  
V.M. Pereira ◽  
A. Marcos-Gonzalez ◽  
I. Radovanovic ◽  
P. Bijlenga ◽  
A.P. Narata ◽  
...  

Ruptured cerebral arteriovenous malformations (AVMs) usually require treatment to avoid re-bleeding. Depending on the angioarchitecture and center strategy, the treatment can be surgical, endovascular, radiosurgical or combined methods. The classic endovascular approach is transarterial, but sometimes it is not always applicable. The transvenous approach has been described as an alternative for the endovascular treatment of small AVMs when arterial access or another therapeutic method is not possible. This approach can be considered when the nidus is small and if there is a single draining vein. We present a technical note on a transvenous approach for the treatment of a ruptured AVM in a young patient.


2020 ◽  
Vol 141 ◽  
pp. 383-388
Author(s):  
Matthew J. Triano ◽  
Jacques Lara-Reyna ◽  
Alexander J. Schupper ◽  
Kurt A. Yaeger

Neurosurgery ◽  
1989 ◽  
Vol 25 (4) ◽  
pp. 599-605 ◽  
Author(s):  
Hunt H. Batjer ◽  
Phillip D. Purdy ◽  
Cole A. Giller ◽  
Duke S. Samson

Abstract The presence of an intracranial arteriovenous malformation has a dramatic impact on local circulatory dynamics. Treatment of some arteriovenous malformations can result in disastrous hyperemic states caused by redistribution of previously shunted blood. This report describes serial hemodynamic measurements of both cerebral blood flow and flow velocity in 3 patients during treatment for arteriovenous malformations. Measurements of cerebral blood flow were made by computed tomographic scan employing the stable xenon inhalation technique; flow velocity, including autoregulatory characteristics, was measured by transcranial Doppler ultrasonogram. Substantial hyperemia developed in one patient (Case 1) after resection and in another (Case 3) after embolization. Embolization resulted in restoration of normal regional cerebral blood flow in a patient who demonstrated hypoperfusion before treatment (Case 2). In Patient 1, postoperative hyperemia was associated with persistently elevated flow velocities, and may have been accompanied by hemispheric neurological deficits. Sequential hemodynamic measurements may predict patients at risk of perioperative complications, and may become useful clinical guidelines for the extent and timing of embolization and for the timing of surgery after intracranial hemorrhage or preoperative embolization procedures.


2001 ◽  
Vol 95 (2) ◽  
pp. 346-349 ◽  
Author(s):  
Francisco A. Ponce ◽  
Patrick P. Han ◽  
Robert F. Spetzler ◽  
Alexa Canady ◽  
Iman Feiz-Erfan

✓ Wyburn-Mason syndrome is a rare condition associated with multiple cerebral arteriovenous malformations. The disease, also called retinoencephalofacial angiomatosis, includes lesions of the retina, brain, and skin. This disorder stems from a vascular dysgenesis of the embryological anterior plexus early in the gestational period when the primitive vascular mesoderm is shared by the involved structures. The timing of the insult to the embryonic tissue determines which structures are affected. Extensions of the lesions vary widely but cutaneous lesions are unusual. Among reports in the literature, only three cases appear to have manifested without retinal involvement. The authors report the fourth case of Wyburn-Mason syndrome in which there was no retinal involvement and the first to involve neither the retina nor the face.


2018 ◽  
Author(s):  
Stanimir Sirakov ◽  
Alexander Sirakov ◽  
Krasimir Minkin ◽  
Hristo Hristov ◽  
Vasil Karakostov

1993 ◽  
Vol 3 (2) ◽  
pp. 161-163 ◽  
Author(s):  
Andrew M. Davis ◽  
Samuel Menahem

SummaryTwo neonates are described presenting in severe cardiac failure within a few hours of birth. Echocardiography and the demonstration by color-coded Doppler of retrograde diastolic flow in the proximal descending aorta suggested the presence of large cerebral arteriovenous malformations. Such lesions were demonstrated by cranial ultrasound. The early diagnosis permitted early intervention, albeit with less than satisfactory outcome.


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