Preembolization Functional Evaluation in Supratentorial Cerebral Arteriovenous Malformations with Superselective Intraarterial Injection of Thiopental Sodium Solution

1994 ◽  
Vol 35 (3) ◽  
pp. 212-216 ◽  
Author(s):  
M. H. Han ◽  
K. H. Chang ◽  
D. H. Han ◽  
K. M. Yeon ◽  
M. C. Han
Keyword(s):  
Brain Function ◽  
Arteriovenous Malformations ◽  
Cerebral Arteries ◽  
External Carotid ◽  
Functional Evaluation ◽  
Neurologic Deficits ◽  
Intraarterial Injection ◽  
Thiopental Sodium ◽  
Local Brain ◽  
Sodium Solution

Superselective intraarterial injections of thiopental sodium solution for evaluation of local brain function were performed before embolization in 38 consecutive patients with supratentorial arteriovenous malformations to evaluate the role of the test using thiopental sodium solution. Thiopental sodium (30–50 mg) was injected in 68 arteries (44 middle cerebral arteries, 13 anterior cerebral arteries, 7 posterior cerebral arteries, 3 external carotid arteries, and 1 thalamo-perforating artery) through superselective microcatheters just before the injection of cyanoacrylate mixture for the embolization. The test was negative in 57 arteries and there were neurologic dysfunctions in 3 of them after embolization. The neurologic deficits in these cases were caused by reflux of embolic material, spasm of the main arterial trunk, or neglected mild sensory change, respectively, and there was no real false-negative test. The embolization could not be performed due to positive test in 9 arteries. Two arteries with positive tests but acceptable symptoms were embolized and the same neurologic deficits developed immediately after embolization. There was no local arterial complication by an injection of the thiopental sodium solution. All neurologic deficits caused by positive tests developed immediately and were completely relieved within 5 min without specific management. Superselective intraarterial injection of thiopental sodium solution is a safe and reliable test for the evaluation of local brain function before embolization of supratentorial arteriovenous malformations.

FEATURES OF HEMODYNAMICS IN HEAD MAGISTRAL AND CEREBRAL ARTERIES IN THE PATIENTS WITH MIGRAINE

2021 ◽  
Vol 74 (10) ◽  
pp. 2489-2493
Author(s):  
Valeriy I. Kalashnikov ◽  
Alexander N. Stoyanov ◽  
Alexander R. Pulyk ◽  
Iryna K. Bakumenko ◽  
Tamara А. Andreeva ◽  
...  
Keyword(s):  
Migraine With Aura ◽  
Migraine Without Aura ◽  
Cerebral Arteries ◽  
Young Patients ◽  
Postgraduate Education ◽  
External Carotid ◽  
Control Group ◽  
Vertebral Arteries ◽  
Hemodynamic Pattern ◽  
Middle Cerebral Arteries

The aim of the study was to Doppler sonography study of the structural and functional state of head magistral arteries (HMA) and cerebral arteries in the patients with various forms of migraine. Materials and methods: We conducted the clinical Doppler examination of 124 young patients (18-45 years old), including 55 men and 69 women in the conditions of the clinical base of the Kharkiv Medical Academy of Postgraduate Education in 2017-2019. The criteria for involvement of patients in the study were: migraine without aura (group 1 – 63 patients), migraine with aura (group 2 – 61 patients) The control group consisted of 45 patients of the corresponding gender and age. The condition of HMA and cerebral arteries was studied using the ultrasound device. Results: The presence of extravasal compressions of vertebral arteries (VA) is typical for the patients with migraine, as well as for some cases of the hypoplasia of the VA in the group of the patients with migraine with aura. In the patients with migraine with aura, there was a decrease in the velocity values in the extracranial VA segments. The velocity values in the external carotid arteries (ECA) were slightly reduced in both groups. The most significant were the changes in the hemodynamics in the middle cerebral arteries (MCA), which were manifested by the pattern of the excessive perfusion in the patients of the migraine without aura and the pattern of the hampered perfusion in the MCA in the patients of the migraine with aura. Conclusions: 1. In the patients with migraine with aura, a decrease in the velocity values in the extracranial segments of the VA was observed, in some cases combined with the hypoplasia of the vertebral artery, the hampered perfusion in middle cerebral arteries. 2. The excessive perfusion in middle cerebral arteries is the most critical hemodynamic pattern in the patients with migraine without aura. 3. The extravasal compression of vertebral arteries, combined with the hyperperfusion in posterior cerebral arteries, is a typical hemodynamic pattern both in the group of the patients with migraine with aura, and in the group of the patients with migraine without aura.

Moyamoya Disease

2019 ◽  
pp. 149-156
Author(s):  
Edward Smith
Keyword(s):  
Moyamoya Disease ◽  
Cerebral Arteries ◽  
Pressure Control ◽  
Vascular Supply ◽  
External Carotid Artery ◽  
External Carotid ◽  
Middle Cerebral Arteries ◽  
Detailed Assessment ◽  
Collateral Vessels ◽  
Carotid Circulation

Moyamoya disease is defined by stenosis of the distal intracranial internal carotid arteries up to and including the bifurcation, with segments of the proximal anterior and middle cerebral arteries, dilated basal collateral vessels, and bilateral findings. Detailed assessment with digital subtraction angiography will define the severity of disease (Suzuki stage) and presence of spontaneous transdural collateral vessels from external carotid artery branches. These collateral vessels must be protected during surgical intervention. The surgical goal is to establish a new vascular supply to the areas of the brain at risk for stroke, utilizing vessels from the external carotid circulation. Blood pressure control and avoidance of hyperventilation are key to minimize perioperative stroke risk. Preoperative hydration, ongoing use of aspirin, and good pain control will also minimize surgical complications.

scholarly journals Peculiar Characteristics of Arteriovenous Malformations Arising in the Galenic Region

Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 481
Author(s):  
Hirohisa Yajima ◽  
Yuki Shinya ◽  
Hirotaka Hasegawa ◽  
Masahiro Shin ◽  
Keisuke Ueki ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Arteriovenous Malformations ◽  
Internal Carotid ◽  
Obstructive Hydrocephalus ◽  
External Carotid Artery ◽  
Vascular Lesions ◽  
External Carotid ◽  
Vein Of Galen ◽  
Vertebrobasilar Artery ◽  
The University

Arteriovenous malformations (AVM) are congenital vascular lesions fed by arterial feeders originating from branches of the internal carotid artery (ICA) or vertebrobasilar artery. We experienced unique AVMs arising in the midline Galenic region, receiving blood supply from the ICA/vertebral artery systems and the external carotid artery system. We retrospectively reviewed data on eight patients who had an AVM arising in the Galenic region and were treated in the University of Tokyo Hospital between 1990 and 2019. The median age at diagnosis was 62 years. Three cases (38%) presented with obstructive hydrocephalus due to aqueduct obstruction caused by an engorged vein of Galen. In all cases, feeders from dural arteries were present and the vein of Galen was the primary drainer. All patients underwent stereotactic radiosurgery. Five patients were followed for > two years; nidus obliteration was confirmed in one, and > 75% shrinkage was confirmed in three, while one patient died due to hemorrhage. Altogether, AVMs arising in the Galenic region are rare and exhibit several peculiar characteristics including the presence of dural feeders, an older age at presentation and presentation with obstructive hydrocephalus.

Brain arteriovenous malformations

Neurology ◽  
2020 ◽  
Vol 95 (20) ◽  
pp. 917-927 ◽  
Author(s):  
Ching-Jen Chen ◽  
Dale Ding ◽  
Colin P. Derdeyn ◽  
Giuseppe Lanzino ◽  
Robert M. Friedlander ◽  
...  
Keyword(s):  
Natural History ◽  
Minimally Invasive ◽  
Arteriovenous Malformations ◽  
Cerebral Arteries ◽  
Treatment Strategies ◽  
Latency Period ◽  
Management Options ◽  
Brain Arteriovenous Malformations ◽  
Risk Of Hemorrhage ◽  
Brain Avms

Brain arteriovenous malformations (AVMs) are anomalous direct shunts between cerebral arteries and veins that convalesce into a vascular nidus. The treatment strategies for AVMs are challenging and variable. Intracranial hemorrhage and seizures comprise the most common presentations of AVMs. However, incidental AVMs are being diagnosed with increasing frequency due to widespread use of noninvasive neuroimaging. The balance between the estimated cumulative lifetime hemorrhage risk vs the risk of intervention is often the major determinant for treatment. Current management options include surgical resection, embolization, stereotactic radiosurgery (SRS), and observation. Complete nidal obliteration is the goal of AVM intervention. The risks and benefits of interventions vary and can be used in a combinatorial fashion. Resection of the AVM nidus affords high rates of immediate obliteration, but it is invasive and carries a moderate risk of neurologic morbidity. AVM embolization is minimally invasive, but cure can only be achieved in a minority of lesions. SRS is also minimally invasive and has little immediate morbidity, but AVM obliteration occurs in a delayed fashion, so the patient remains at risk of hemorrhage during the latency period. Whether obliteration can be achieved in unruptured AVMs with a lower risk of stroke or death compared with the natural history of AVMs remains controversial. Over the past 5 years, multicenter prospective and retrospective studies describing AVM natural history and treatment outcomes have been published. This review provides a contemporary and comprehensive discussion of the natural history, pathobiology, and interventions for brain AVMs.

scholarly journals Concurrent Stenoocclusive Disease of Intracranial and Extracranial Arteries in a Patient with Polycythemia Vera

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Le H. Hua ◽  
Robert L. Dodd ◽  
Neil E. Schwartz
Keyword(s):  
Polycythemia Vera ◽  
Internal Carotid ◽  
Systemic Vasculitis ◽  
Cerebral Arteries ◽  
Occlusive Disease ◽  
External Carotid ◽  
Hematologic Disorders ◽  
Percutaneous Balloon ◽  
Vessel Imaging ◽  
Percutaneous Balloon Angioplasty

Moyamoya disease is a stenoocclusive disease involving the intracranial carotid and proximal middle cerebral arteries. There are rarely any additional extracranial stenoses occurring concurrently with moyamoya. The pathophysiology of moyamoya remains obscure, but hematologic disorders, notably sickle-cell anemia, have been associated in some cases. We describe the novel case of polycythemia vera associated with severe steno-occlusive disease of both intracranial and extracranial large arteries. A 47-year-old woman with polycythemia vera had multiple transient ischemic attacks, and noninvasive vessel imaging revealed steno-occlusive disease of bilateral supraclinoid internal carotid arteries with moyamoya-type collaterals, proximal left subclavian artery, right vertebral artery origin, bilateral renal arteries, superior mesenteric artery, and right common iliac artery. Laboratory workup for systemic vasculitis was negative. She required bilateral direct external carotid to internal carotid bypass procedures and percutaneous balloon angioplasty of her right VA origin stenosis. This case suggests that hematologic disorders can lead to vessel stenoses and occlusion. The pathophysiology may be due to a prothrombotic state leading to repeated endothelial injury, resultant intimal hyperplasia, and progressive steno-occlusion.

Combined Embolization and Gamma Knife Radiosurgery for Cerebral Arteriovenous Malformations

1993 ◽  
Vol 34 (6) ◽  
pp. 600-606 ◽  
Author(s):  
W. Y. Guo ◽  
G. Wikholm ◽  
B. Karlsson ◽  
C. Lindquist ◽  
P. Svendsen ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Arteriovenous Malformations ◽  
Combined Treatment ◽  
Time Lag ◽  
Gamma Knife Radiosurgery ◽  
Cerebral Arteriovenous Malformations ◽  
Neurologic Deficits ◽  
Feeding Vessels ◽  
Grade Iii

In a study of 46 patients with cerebral arteriovenous malformations (AVMs) the value of combining embolization and gamma knife radiosurgery was assessed. In 35 patients with large grade III to V AVMs (Spetzler-Martin system) staged combined treatment was planned. In 11 patients, radiosurgery complemented embolization for a residual AVM. The number of embolization sessions ranged from 1 to 7 (median 2). Twenty-six patients needed multiple embolization sessions. In 28 patients the grade of AVMs decreased as a result of embolization. In 16 patients collateral feeding vessels developed after embolization which made delineation of the residual nidus difficult. The time lag between the last embolization and radiosurgery ranged from 1 to 24 months (median 4). Nineteen of 35 large grade III to V AVMs were possible to treat by radiosurgery following embolization. In the 46 patients complications occurred in 9 from embolization and in 2 from radiosurgery. Two patients had transient and 9 had permanent neurologic deficits. It is concluded that embolization facilitates radiosurgery for some large AVMs and therefore this combined treatment has a role in the management of AVMs.

Intraparenchymal arteriovenous malformations with predominant external carotid artery contribution

1974 ◽  
Vol 41 (6) ◽  
pp. 681-687 ◽  
Author(s):  
Raymond E. Dahl ◽  
David G. Kline
Keyword(s):  
Carotid Artery ◽  
Blood Supply ◽  
Arteriovenous Malformations ◽  
External Carotid Artery ◽  
External Carotid ◽  
Content Type ◽  
Cerebral Parenchyma ◽  
Fine Print

✓ Arteriovenous malformations located within cerebral parenchyma are usually supplied by intracranial vessels. An extracranial blood supply to these lesions is rare. The authors report their experience with two such cases and discuss the 21 comparable reports.

scholarly journals Elevated Intraocular Pressure due to Arteriovenous Fistula between External Carotid Artery and Facial Vein

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Halil Huseyin Cagatay ◽  
Metin Ekinci ◽  
Selam Yekta Sendul ◽  
Ceylan Uslu ◽  
Mehmet Demir ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Carotid Artery ◽  
Arteriovenous Malformations ◽  
Venous Pressure ◽  
External Carotid Artery ◽  
External Carotid ◽  
Arteriovenous Fistulas ◽  
Intraocular Pressure Elevation ◽  
Functional Neck Dissection ◽  
Conjunctival Vessels

Aqueous outflow via the conventional outflow pathway is dependent on the pressure gradient between intraocular pressure (IOP) and episcleral venous pressure (EVP). Elevated IOP resulting from increased EVP is a well-known complication of arteriovenous fistulas, which are usually between the carotid artery and the cavernous sinus. Arteriovenous malformations usually occur spontaneously, after a trauma or from iatrogenic causes, and they manifest with findings of chemosis, dilatation of the conjunctival vessels, exophthalmos, and extraocular motility limitation. In this study, we present a case of elevated IOP due to facial arteriovenous malformations following a functional neck dissection surgery that caused intraocular pressure elevation.

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