Arteriovenous Malformation

2018 ◽  
Author(s):  
Allison Spinelli ◽  
Liang Huang
Keyword(s):  
Arteriovenous Malformation ◽  
Interventional Neuroradiology ◽  
Endovascular Embolization ◽  
Young Population ◽  
Management Options ◽  
Stereotactic Radiation ◽  
The Past ◽  
Radiation Management ◽  
Arteries And Veins ◽  
The Brain

Arteriovenous malformation (AVM) is an abnormal connection between arteries and veins, bypassing the capillary system, which may occur in the brain or the spinal cord. AVMs are challenging to diagnose, and the symptoms may be subtle or dramatic. The location and extent of the lesion will determine its potential for morbidity as these lesions also affect a young population. Most importantly, the technology and evolution of treatment for AVMs has changed dramatically over the past two decades and now incorporates interventional neuroradiology and stereotactic radiation. Management options include conservative management, surgical resection, endovascular embolization, and stereotactic surgery. This chapter’s discussion will cover surgical and interventional modes of treatment of cerebral AVMs.

scholarly journals Nongalenic arteriovenous fistulas: history of treatment and technology

2006 ◽  
Vol 20 (6) ◽  
pp. 1-8 ◽  
Author(s):  
Kristen Upchurch ◽  
Lei Feng ◽  
Gary R. Duckwiler ◽  
John G. Frazee ◽  
Neil A. Martin ◽  
...  
Keyword(s):  
Open Surgery ◽  
Interventional Neuroradiology ◽  
Endovascular Embolization ◽  
High Flow ◽  
Vascular Lesions ◽  
Arteriovenous Fistulas ◽  
The Past ◽  
Technological Developments ◽  
History Of ◽  
Endovascular Technology

✓ Nongalenic cerebral arteriovenous fistulas (AVFs) are uncommon, high-flow vascular lesions first treated by Walter Dandy and his colleagues by using open surgery with ligation of the feeding artery. Due to advances in endovascular technology over the past four decades that make possible the control of high flow in AVFs, treatment has evolved from the sole option of surgery to include the alternative or adjunct option of endovascular embolization. The authors of this review discuss the history of nongalenic AVF treatment, including techniques of both surgery and interventional neuroradiology and the technological developments underlying them.

Endovascular Embolization With Cyanoacrylate Mixtures: An In Vivo Study of Polymerization Kinetics

2001 ◽  
Author(s):  
Matthew J. Gounis ◽  
Baruch B. Lieber ◽  
L. N. Hopkins
Keyword(s):  
Brain Structures ◽  
Vascular Lesion ◽  
Endovascular Embolization ◽  
Embolic Agent ◽  
Adjunct Treatment ◽  
Arterial Blood ◽  
Ethiodized Oil ◽  
Arteries And Veins ◽  
The Brain

Abstract A cerebral arteriovenous malformation (AVM) is a congenital vascular lesion of the brain composed of a complex tangle of arteries and veins, which are linked by one or more fistulae [1]. Arterial blood is shunted through the AVM directly to the venous system, precluding arterial blood from perfusing adjacent brain structures. The most common presentation of this disease is cerebral hemorrhage secondary to AVM rupture, with an associated mortality of 15% and a morbidity of 50% [1]. One modality to treat this pathology is endovascular embolization. Generally, endovascular embolization serves as an adjunct treatment to either surgery or radiosurgery, but is a curative treatment in approximately 15% of AVM cases [2]. The most common embolic agent used to occlude AVMs is a mixture of n-butyl 2-cyanoacrylate (NBCA) and Lipiodol®. NBCA is a rapidly polymerizing liquid adhesive that polymerizes with contact to blood. Lipiodol® is an ethiodized oil, which imparts radiopacity to the embolic mixture. Moreover, Lipiodol® has been reported to delay the polymerization of NBCA [3]. To further increase the polymerization time of NBCA, minute quantities of glacial acetic acid (GAA) may be added to the embolic mixture.

Neuro-Clinical Signatures of Language Impairments: A Theoretical Framework for Function-to-structure Mapping in Clinics

2020 ◽  
Vol 20 (9) ◽  
pp. 800-811 ◽  
Author(s):  
Ferath Kherif ◽  
Sandrine Muller
Keyword(s):  
Brain Mapping ◽  
Theoretical Framework ◽  
Brain Regions ◽  
Language Impairments ◽  
Structure Mapping ◽  
Language Functions ◽  
The Past ◽  
Language Recovery ◽  
The Brain ◽  
Bow Tie

In the past decades, neuroscientists and clinicians have collected a considerable amount of data and drastically increased our knowledge about the mapping of language in the brain. The emerging picture from the accumulated knowledge is that there are complex and combinatorial relationships between language functions and anatomical brain regions. Understanding the underlying principles of this complex mapping is of paramount importance for the identification of the brain signature of language and Neuro-Clinical signatures that explain language impairments and predict language recovery after stroke. We review recent attempts to addresses this question of language-brain mapping. We introduce the different concepts of mapping (from diffeomorphic one-to-one mapping to many-to-many mapping). We build those different forms of mapping to derive a theoretical framework where the current principles of brain architectures including redundancy, degeneracy, pluri-potentiality and bow-tie network are described.

Chemo- and Optogenetic Strategies for the Elucidation of Pain Pathways

2019 ◽  
pp. 816-832 ◽  
Author(s):  
Sascha R. A. Alles ◽  
Anne-Marie Malfait ◽  
Richard J. Miller
Keyword(s):  
Chronic Pain ◽  
Pain Response ◽  
Conscious Perception ◽  
Novel Therapies ◽  
The Past ◽  
Nociceptive Pathways ◽  
Pain Pathways ◽  
Technical Advances ◽  
The Brain

Pain is not a simple phenomenon and, beyond its conscious perception, involves circuitry that allows the brain to provide an affective context for nociception, which can influence mood and memory. In the past decade, neurobiological techniques have been developed that allow investigators to elucidate the importance of particular groups of neurons in different aspects of the pain response, something that may have important translational implications for the development of novel therapies. Chemo- and optogenetics represent two of the most important technical advances of recent times for gaining understanding of physiological circuitry underlying complex behaviors. The use of these techniques for teasing out the role of neurons and glia in nociceptive pathways is a rapidly growing area of research. The major findings of studies focused on understanding circuitry involved in different aspects of nociception and pain are highlighted in this article. In addition, attention is drawn to the possibility of modification of chemo- and optogenetic techniques for use as potential therapies for treatment of chronic pain disorders in human patients.

scholarly journals DNA Methylation Profiles of Tph1A and BDNF in Gut and Brain of L. Rhamnosus-Treated Zebrafish

Biomolecules ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 142
Author(s):  
Mariella Cuomo ◽  
Luca Borrelli ◽  
Rosa Della Monica ◽  
Lorena Coretti ◽  
Giulia De Riso ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Molecular Mechanisms ◽  
The Past ◽  
Targeted Analysis ◽  
Lack Of Information ◽  
High Resolution Power ◽  
Resolution Level ◽  
Health And Disease ◽  
High Doses ◽  
The Brain

The bidirectional microbiota–gut–brain axis has raised increasing interest over the past years in the context of health and disease, but there is a lack of information on molecular mechanisms underlying this connection. We hypothesized that change in microbiota composition may affect brain epigenetics leading to long-lasting effects on specific brain gene regulation. To test this hypothesis, we used Zebrafish (Danio Rerio) as a model system. As previously shown, treatment with high doses of probiotics can modulate behavior in Zebrafish, causing significant changes in the expression of some brain-relevant genes, such as BDNF and Tph1A. Using an ultra-deep targeted analysis, we investigated the methylation state of the BDNF and Tph1A promoter region in the brain and gut of probiotic-treated and untreated Zebrafishes. Thanks to the high resolution power of our analysis, we evaluated cell-to-cell methylation differences. At this resolution level, we found slight DNA methylation changes in probiotic-treated samples, likely related to a subgroup of brain and gut cells, and that specific DNA methylation signatures significantly correlated with specific behavioral scores.

scholarly journals The Microbiota–Gut–Brain Axis and Alzheimer Disease. From Dysbiosis to Neurodegeneration: Focus on the Central Nervous System Glial Cells

2021 ◽  
Vol 10 (11) ◽  
pp. 2358
Author(s):  
Maria Grazia Giovannini ◽  
Daniele Lana ◽  
Chiara Traini ◽  
Maria Giuliana Vannucchi
Keyword(s):  
Alzheimer Disease ◽  
Glial Cells ◽  
Cell Types ◽  
The Past ◽  
The Central Nervous System ◽  
Diseased State ◽  
The Brain ◽  
Alzheimer Disease Pathogenesis ◽  
Brain Homeostasis

The microbiota–gut system can be thought of as a single unit that interacts with the brain via the “two-way” microbiota–gut–brain axis. Through this axis, a constant interplay mediated by the several products originating from the microbiota guarantees the physiological development and shaping of the gut and the brain. In the present review will be described the modalities through which the microbiota and gut control each other, and the main microbiota products conditioning both local and brain homeostasis. Much evidence has accumulated over the past decade in favor of a significant association between dysbiosis, neuroinflammation and neurodegeneration. Presently, the pathogenetic mechanisms triggered by molecules produced by the altered microbiota, also responsible for the onset and evolution of Alzheimer disease, will be described. Our attention will be focused on the role of astrocytes and microglia. Numerous studies have progressively demonstrated how these glial cells are important to ensure an adequate environment for neuronal activity in healthy conditions. Furthermore, it is becoming evident how both cell types can mediate the onset of neuroinflammation and lead to neurodegeneration when subjected to pathological stimuli. Based on this information, the role of the major microbiota products in shifting the activation profiles of astrocytes and microglia from a healthy to a diseased state will be discussed, focusing on Alzheimer disease pathogenesis.

scholarly journals Pulmonary arteriovenous malformation (PAVM) embolization: prediction of angiographically-confirmed recanalization according to PAVM Diameter changes on CT

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Jihoon Hong ◽  
Sang Yub Lee ◽  
Jung Guen Cha ◽  
Jae-Kwang Lim ◽  
Jongmin Park ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Case Series ◽  
Pulmonary Angiography ◽  
Endovascular Embolization ◽  
Pulmonary Arteriovenous Malformation ◽  
Conventional Angiography ◽  
Receiver Operating Characteristic Curves ◽  
Vein Diameter ◽  
Diameter Reduction

Abstract Background To assess pulmonary arteriovenous malformation (PAVM) recanalization after embolization based on PAVM diameter changes on computed tomography (CT), with pulmonary angiography used as a gold standard. Methods A retrospective review was done of patients from 2008 to 2019 with a PAVM treated with endovascular embolization. The treatment outcome was determined by conventional angiography. Follow-up pulmonary angiography was performed when recanalization was suspected on CT, or embolization of all lesions in multiple PAVM patients could not be completed in a single session. Patients who had no preprocedural or follow-up CT were excluded. Draining vein, feeding artery, and venous sac diameter were measured on CT, and diameter reduction rates were compared with the widely-used, binary 70 % criteria. Results Forty-one patients with 114 PAVMs were treated during the study period. Eight patients with 50 PAVMs met the inclusion criteria. Mean vein, artery, and venous sac diameter reduction rates were as follows: 59.2 ± 9.3 %, 47.5 ± 10.6 %, and 62.6 ± 13.2 %, respectively, in the occluded group and 5.4 ± 19.5 %, 11.3 ± 17.7 %, and 26.8 ± 14.2 %, respectively, in the recanalized group. The area under the receiver operating characteristic curves for PAVM recanalization for the draining vein was 1.00, showing a better result than the artery (0.97) and sac (0.99). Patients showed > 42 % draining vein diameter reduction in the occluded group and < 32 % in the recanalized group. The widely-used 70 % criteria showed low specificity for predicting recanalization (draining vein, 7.3 %; venous sac, 41.7 %) but 100 % sensitivity for both the draining vein and venous sac. Conclusions The widely-used 70 % binary criteria showed limited performance in predicting outcomes in this angiographically-confirmed case series. Further investigations are warranted to establish a strategy for detecting recanalization after PAVM embolization.

scholarly journals Multidisciplinary Approach to Suspected Sudden Death Caused by Arteriovenous Malformation Rupture: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 644
Author(s):  
Federico Giuseppe Patanè ◽  
Massimiliano Esposito ◽  
Andrea Giovanni Musumeci ◽  
Monica Palermo ◽  
Marco Torrisi ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Cause Of Death ◽  
Venous Malformation ◽  
Healthy Woman ◽  
Unexpected Death ◽  
Medical Problems ◽  
Variable Diameter ◽  
Life Threatening ◽  
Brain Avms ◽  
The Brain

Arteriovenous malformations (AVMs) are rare congenital conditions with a prevalence of less than 1% and are mostly asymptomatic. However, these malformations can suddenly cause intense pain or bleeding, leading to life-threatening medical problems. This report presents a case of an unexpected death in a 37-year-old previously healthy woman due to an intra-cerebellum arteriovenous malformation rupture identified during autopsy. While infective processes where preliminarily excluded, a Post Mortem Computed Tomography (PMCT) identified a tetra ventricular hemorrhage and intra-cerebellum hemorrhage. Toxicological examination was negative for most substances of abuse. During autopsy an intense hemorrhagic infiltrate in the subarachnoid space was observed. After formalin fixation of the brain the cerebellum showed hemorrhagic infarction on fourth ventricle sides, as well as several small reddish infarctions across the entire cerebellum parenchyma. Histological examination of the brain and cerebellum showed a suffusion of erythrocytes in the sub-arachnoid region. Evidence of an arterio-venous malformation, with several intertwine vessels of variable diameter, surrounded by hemorrhagic evidence. The autopsy played a crucial role in identifying the location and the possibly affected vessel, as well as defining the cause of death. It is necessary to have a greater number of autopsies to make an epidemiological contribution. Furthermore, it is crucial to create a multicenter data network with other authors from other departments to improve information about epidemiological, clinical, diagnostic and therapeutic data. Most brain AVMs as cause of death are often undiscovered.

Vascular Reconstruction of a Brachial Artery Aneurysm Proximally to an Arteriovenous Malformation

2019 ◽  
Vol 54 (1) ◽  
pp. 75-79
Author(s):  
Curtis Woodford ◽  
Elizabeth Tai ◽  
Sebastian Mafeld ◽  
Husain A. Al-Mubarak ◽  
Arash Jaberi ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Radial Artery ◽  
Brachial Artery ◽  
Arteriovenous Malformations ◽  
Femoral Vein ◽  
Artery Aneurysm ◽  
Vascular Reconstruction ◽  
Endovascular Embolization ◽  
Antecubital Fossa ◽  
Interposition Graft

Brachial artery aneurysms and arteriovenous malformations (AVM) are limb-threatening vascular anomalies. This patient presented with a bilobed brachial artery aneurysm in the antecubital fossa proximally to an AVM arising from the dorsal interosseous and ulnar arteries that had been treated with endovascular embolization, leaving the hand solely supplied by the radial artery. The aneurysm continued to increase in size and imaging revealed concomitant thrombus. A femoral vein interposition graft was used to repair the aneurysm, and postoperatively, the patient retained full left arm function.

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