scholarly journals Anaesthesia for Closed Embolisation of Cerebral Arteriovenous Malformations

1988 ◽  
Vol 16 (3) ◽  
pp. 318-323 ◽  
Author(s):  
B. J. O'Mahony ◽  
S. N. C. Bolsin
Keyword(s):  
Arteriovenous Malformation ◽  
Glyceryl Trinitrate ◽  
Sodium Nitroprusside ◽  
Arteriovenous Malformations ◽  
Anaesthetic Management ◽  
Cerebral Arteriovenous Malformation ◽  
Vascular Network ◽  
Arterial Hypotension ◽  
Cerebral Arteriovenous Malformations ◽  
Neurological Assessment

Cerebral arteriovenous malformation embolisation is a therapeutic, neuroradiological procedure involving injection of bucrylate glue into the nidus of the A V malformation to obliterate the abnormal vascular network. These procedures may involve significant risks, are often long and thereby necessitate the need for some form of sedation and for adequate monitoring of the cerebral, cardiovascular and respiratory systems. The anaesthetic management of a series of twenty patients undergoing embolisation of a cerebral arteriovenous malformation is outlined, seven general and nineteen neurolept anaesthetics being administered. Neurolept anaesthesia is the preferred technique as neurological assessment during the procedure is possible and complications may be diagnosed immediately. Systemic arterial hypotension may facilitate the embolisation process and various agents, including glyceryl trinitrate and sodium nitroprusside, have been employed for this purpose.

Retrograde flow in the distal aortic arch and proximal descending aorta—a clue to presence of a major cerebral arteriovenous malformation

1993 ◽  
Vol 3 (2) ◽  
pp. 161-163 ◽  
Author(s):  
Andrew M. Davis ◽  
Samuel Menahem
Keyword(s):  
Early Diagnosis ◽  
Arteriovenous Malformation ◽  
Cardiac Failure ◽  
Arteriovenous Malformations ◽  
Cerebral Arteriovenous Malformation ◽  
Cranial Ultrasound ◽  
Retrograde Flow ◽  
Cerebral Arteriovenous Malformations ◽  
Descending Aorta ◽  
Satisfactory Outcome

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.

scholarly journals Seizures after Onyx Embolization for the Treatment of Cerebral Arteriovenous Malformation

2011 ◽  
Vol 17 (3) ◽  
pp. 331-338 ◽  
Author(s):  
K. De Los Reyes ◽  
A. Patel ◽  
A. Doshi ◽  
N. Egorova ◽  
F. Panov ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Retrospective Review ◽  
Arteriovenous Malformations ◽  
Clinical History ◽  
Median Number ◽  
Cerebral Arteriovenous Malformation ◽  
Brain Arteriovenous Malformation ◽  
Cerebral Arteriovenous Malformations ◽  
History Of ◽  
New Onset

Onyx embolization of cerebral arteriovenous malformations (AVM) has become increasingly common. We explored the risk of seizures after Onyx use. A retrospective review was conducted of 20 patients with supratentorial brain arteriovenous malformation (AVM) who received Onyx embolization between 2006 and 2009. Baseline demographics, clinical history, seizure history, AVM characteristics and treatment were compared between those who developed post-onyx seizure and those who did not. MRIs were reviewed for edema following Onyx treatment. Of 20 patients who underwent Onyx embolization, the initial AVM presentation was hemorrhage in 40% (N=8). The median number of embolizations was two (range 1–4) and the median final obliteration amount was 90% (range 50–100%). A history of seizure was present in 50% (N=10) of patients pre-embolization and 12 (60%) patients received seizure medications (treatment or prophylaxis) prior to embolization. Seizur post-Onyx embolization occurred in 45% (N=9). The median time to seizur post-Onyx was seven days (range 0.3–210). Four patients (20%) with seizures post-Onyx had no seizure history. Two of these patients (10%) had no other identifiable cause for seizure other than recent Onyx embolization. Seizures in these two patients occurred within 24 hours of Onyx administration. Among patients with post-Onyx seizures, there was a trend toward larger AVM size (P=0.091) and lower percent obliteration (P=0.062). Peri-AVM edema was present in 75% of MRIs performed within one month of Onyx treatment and may represent a possible etiology for seizures. New onset seizures post-Onyx embolization are not uncommon. Further study of seizure prevention is warranted.

Spontaneous subarachnoid hemorrhage first from an intracranial and then from a spinal arteriovenous malformation

1977 ◽  
Vol 47 (6) ◽  
pp. 965-968 ◽  
Author(s):  
Dwight Parkinson ◽  
Michael West
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Cerebral Arteriovenous Malformation ◽  
Cerebral Arteriovenous Malformations ◽  
Content Type ◽  
Spinal Arteriovenous Malformation ◽  
Spontaneous Subarachnoid Hemorrhage ◽  
Spinal Avm ◽  
Fine Print

✓ A patient presented with spontaneous subarachnoid hemorrhage (SAH) from a cerebral arteriovenous malformation (AVM) which was later totally removed at surgery. The patient presented again with a new SAH from a spinal AVM that was also totally removed at surgery. Coexistence of spinal and cerebral arteriovenous malformations are exceedingly rare and hemorrhage from each is not previously reported. This case emphasizes the importance of investigating the spinal canal in otherwise unexplained spontaneous SAH.

Screening for arteriovenous malformations in hereditary haemorrhagic telangiectasia

2016 ◽  
Vol 130 (8) ◽  
pp. 734-742 ◽  
Author(s):  
S Jervis ◽  
D Skinner
Keyword(s):  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Gastrointestinal Endoscopy ◽  
Case Note ◽  
Cerebral Arteriovenous Malformation ◽  
Upper Gastrointestinal Endoscopy ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Cerebral Arteriovenous Malformations ◽  
Retrospective Case ◽  
Upper Gastrointestinal

AbstractObjective:To determine whether patients with hereditary haemorrhagic telangiectasia were being screened according to international guidelines, and to review recent evidence in order to provide up-to-date guidelines for the initial systemic management of hereditary haemorrhagic telangiectasia.Methods:A retrospective case note analysis was conducted, assessing patients in terms of screening for: genetics, cerebral arteriovenous malformations, pulmonary and hepatic arteriovenous malformations, and gastrointestinal telangiectasia. Databases searched included Medline, the Cumulative Index to Nursing and Allied Health Literature, and Embase.Results:Screening investigations were most frequently performed for hepatic arteriovenous malformations and least frequently for genetics. Recent data suggest avoiding routine genetic and cerebral arteriovenous malformation screening because of treatment morbidities; performing high-resolution chest computed tomography for pulmonary arteriovenous malformation screening; using capsule endoscopy (if possible) to reduce complications from upper gastrointestinal endoscopy; and omitting routine liver enzyme testing in favour of Doppler ultrasound.Conclusion:Opportunities for systemic arteriovenous malformation screening are frequently overlooked. This review highlights the need for screening and considers the form in which it should be undertaken.

scholarly journals Intrarater and interrater reliability of the pediatric arteriovenous malformation compactness score in children

2013 ◽  
Vol 11 (5) ◽  
pp. 547-551 ◽  
Author(s):  
Fabio A. Frisoli ◽  
Shih-Shan Lang ◽  
Arastoo Vossough ◽  
Anne Marie Cahill ◽  
Gregory G. Heuer ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Recurrence Rate ◽  
Arteriovenous Malformations ◽  
Interrater Reliability ◽  
Intrarater Reliability ◽  
Cerebral Arteriovenous Malformations ◽  
Perfect Agreement ◽  
Interventional Radiologist ◽  
Κ Statistic

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.

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

1988 ◽  
Vol 15 (2) ◽  
pp. 130-134 ◽  
Author(s):  
Douglas Kondziolka ◽  
Bruce J. Nixon ◽  
Pierre Lasjaunias ◽  
Pierre Lasjaunias ◽  
William S. Tucker ◽  
...  
Keyword(s):  
Blood Flow ◽  
Arteriovenous Malformation ◽  
Endovascular Treatment ◽  
Arteriovenous Malformations ◽  
Local Blood Flow ◽  
Cerebral Arteriovenous Malformations ◽  
Regional Hemodynamics ◽  
The Common ◽  
Arterial Aneurysms ◽  
Therapeutic Considerations

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.

Associated arteriovenous malformation of the orbit and brain: a case of Wyburn-Mason syndrome without retinal involvement

2001 ◽  
Vol 95 (2) ◽  
pp. 346-349 ◽  
Author(s):  
Francisco A. Ponce ◽  
Patrick P. Han ◽  
Robert F. Spetzler ◽  
Alexa Canady ◽  
Iman Feiz-Erfan
Keyword(s):  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Rare Condition ◽  
Cerebral Arteriovenous Malformations ◽  
Cutaneous Lesions ◽  
Content Type ◽  
Gestational Period ◽  
Fourth Case ◽  
The Face ◽  
Fine Print

✓ 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.

scholarly journals Known and unknown cerebral arteriovenous malformations in pregnancies: haemorrhage risk and influence on obstetric management

2017 ◽  
Vol 30 (5) ◽  
pp. 437-441 ◽  
Author(s):  
Xianli Lv ◽  
Wei Li ◽  
Hongwei He ◽  
Chuhan Jiang ◽  
Youxiang Li
Keyword(s):  
Caesarean Section ◽  
Confidence Interval ◽  
Arteriovenous Malformation ◽  
Vaginal Delivery ◽  
Arteriovenous Malformations ◽  
Cerebral Arteriovenous Malformations ◽  
Haemorrhage Risk ◽  
Pregnancy History ◽  
Obstetric Management ◽  
Haemorrhage Rate

Objective The objective of this study was to evaluate the haemorrhage risk of known and unknown cerebral arteriovenous malformations and their obstetric management. Methods A retrospective review was performed and analysed 67 consecutive cases of arteriovenous malformation with pregnancy history. Results Sixty-seven cases of arteriovenous malformation with pregnancy histories were identified. In 14 cases (20.9%) of arteriovenous malformation diagnosed before pregnancy, 11 cases were treated (10 embolisation and one surgery), there was no haemorrhage in 14 pregnancies, 14 healthy babies were delivered by caesarean section in 12 pregnancies (85.7%) and vaginal delivery in two pregnancies (14.3%). In 53 cases (89.1%) of arteriovenous malformation diagnosed during/after pregnancy, there was one (1.6%) case of subarachnoid haemorrhage at 38 weeks’ gestation in 64 pregnancies, 64 healthy babies were delivered by caesarean section in 11 pregnancies (17.2%) and vaginal delivery in 53 pregnancies (82.8%). This resulted in 1.6% (95% confidence interval 0–4.6%) haemorrhage rate per pregnancy in unknown arteriovenous malformations. Known arteriovenous malformation gravida was prone to caesarean section; however, vaginal delivery did not increase the haemorrhage risk in unknown arteriovenous malformation gravidas (1.8% vs. 0%, P = 1.000). Conclusion Prior treatment for ruptured arteriovenous malformation could prevent its haemorrhage during pregnancy and the haemorrhage risk of unruptured arteriovenous malformation in pregnancies is low. Although known arteriovenous malformation gravida is prone to caesarean section, vaginal delivery seems not to increase the haemorrhage risk in unknown arteriovenous malformation gravidas.

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