Advances and Innovations in Brain Arteriovenous Malformation Surgery

Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S60-S73 ◽  
Author(s):  
Bernard R. Bendok ◽  
Najib E. El Tecle ◽  
Tarek Y. El Ahmadieh ◽  
Antoun Koht ◽  
Thomas A. Gallagher ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Brain Arteriovenous Malformation ◽  
Endovascular Techniques ◽  
Initial Description ◽  
The 19Th Century ◽  
The Brain ◽  
Quantitative Assessments

Abstract Arteriovenous malformations (AVMs) of the brain are very complex and intriguing pathologies. Since their initial description by Luschka and Virchow in the middle of the 19th century, multiple advances and innovations have revolutionized their management and surgical treatment. Here, we review the historical landmarks in the surgical treatment of AVMs and then illustrate the most recent and futuristic technologies aiming to improve outcomes in AVM surgeries. In particular, we examine potential advances in patient selection, imaging, surgical technique, neuroanesthesia, and postoperative neuro-rehabilitation and quantitative assessments. Finally, we illustrate how concurrent advances in radiosurgery and endovascular techniques might present new opportunities to treat AVMs more safely from a surgical perspective.

Arteriovenous malformations in the posterior fossa

1977 ◽  
Vol 47 (1) ◽  
pp. 50-56 ◽  
Author(s):  
Hiroshi Matsumura ◽  
Yasumasa Makita ◽  
Kuniyuki Someda ◽  
Akinori Kondo
Keyword(s):  
Arteriovenous Malformation ◽  
Brain Stem ◽  
Posterior Fossa ◽  
Arteriovenous Malformations ◽  
Cerebellopontine Angle ◽  
Anterior Part ◽  
Content Type ◽  
The Brain ◽  
Fine Print

✓ We have operated on 12 of 14 cases of arteriovenous malformation (AVM) in the posterior fossa since 1968, with one death. The lesions were in the cerebellum in 10 cases (three anteromedial, one central, three lateral, and three posteromedial), and in the cerebellopontine angle in two; in two cases the lesions were directly related to the brain stem. The AVM's in the anterior part of the cerebellum were operated on through a transtentorial occipital approach.

scholarly journals Odilon Marc Lannelongue (1840–1911) and strip craniectomy for craniosynostosis

2014 ◽  
Vol 36 (4) ◽  
pp. E16 ◽  
Author(s):  
Shyamal C. Bir ◽  
Sudheer Ambekar ◽  
Christina Notarianni ◽  
Anil Nanda
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
19Th Century ◽  
Sagittal Synostosis ◽  
The 19Th Century ◽  
French Surgeon ◽  
Strip Craniectomy

In the 19th century, Dr. Odilon Marc Lannelongue was a pioneering French surgeon who introduced a surgical technique for the treatment of craniosynostosis. In 1890, Dr. Lannelongue performed correction of sagittal synostosis by strip craniectomy. From his procedure, multiple techniques have been developed and endorsed for this condition, ranging from simple suturectomies to extensive calvarial vault remodeling. In addition, even today, endoscopically aided strip craniectomy is performed as a surgical treatment of craniosynostosis. This article describes the life and works of the surgeon who revolutionized the management of craniosynostosis.

scholarly journals Successful treatment of bilateral multiple pulmonary arteriovenous malformations in a patient with brain abscess and severe hypoxemia using a combination of transcatheter embolotherapy and surgical resection: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Takahiro Ochi ◽  
Masako Chiyo ◽  
Takamasa Ito ◽  
Hideharu Furumoto ◽  
Toshihiko Sugiura ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Brain Abscess ◽  
Surgical Resection ◽  
Arteriovenous Malformations ◽  
Pulmonary Arteriovenous Malformation ◽  
Positive Pressure ◽  
Pulmonary Arteriovenous Malformations ◽  
Severe Hypoxemia ◽  
History Of ◽  
The Brain

Abstract Background A pulmonary arteriovenous malformation is an abnormal dilated blood vessel that makes direct communication between a pulmonary artery and pulmonary vein and can be associated with hypoxemia or neurological complications, including brain abscess and cerebral infarction. Treatment of pulmonary arteriovenous malformation includes surgical resection and transcatheter embolotherapy, however the adaptation of therapies should be considered when a patient is in bad condition. Case presentation A 51-year-old man was admitted after developing fever, consciousness disorder, and hypoxemia. Magnetic resonance imaging of the brain showed a brain abscess. Bilateral pulmonary arteriovenous malformations were found by contrast computed tomography. Because of a family history of pulmonary arteriovenous malformation, a history of epistaxis, and the existence of oral mucosa telangiectasia, he was diagnosed with hereditary hemorrhagic telangiectasia and brain abscess caused by intrapulmonary right-to-left shunt. The brain abscess improved with antibiotic treatment; however, the administration of oxygen did not ameliorate his hypoxemia. His hypoxemia was exacerbated by positive pressure ventilation. Considering his systemic and respiratory condition, we considered surgery to involve a high degree of risk. After controlling his brain abscess and pneumonia, transcatheter embolotherapy was performed. This improved his systemic condition, enabling surgical treatment. Conclusions This middle-aged patient suffering from brain abscess and severe hypoxemia with multiple pulmonary arteriovenous malformations was successfully treated by a combination of transcatheter embolotherapy and surgery. The adaptation and combination of therapies, as well as the sequence of treatments, should be considered depending on the patient status and lesions.

Unruptured Eloquent Arteriovenous Malformation Presenting with Arm Weakness

2019 ◽  
pp. 215-224
Author(s):  
Adeel Ilyas ◽  
Dale Ding ◽  
Matthew J. Shepard ◽  
Jason P. Sheehan
Keyword(s):  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Inverse Relationship ◽  
Medical Condition ◽  
Noninvasive Treatment ◽  
Neurological Morbidity ◽  
Treatment Volume ◽  
Work Up ◽  
The Brain ◽  
Surgical Extirpation

Abstract: Cerebral arteriovenous malformations are often located in regions of the brain that are not surgically accessible, or they are found in patients who are not candidates for microsurgery. If the expected neurological morbidity of surgical extirpation is unacceptably high, or if the patient’s medical condition presents an unacceptable risk for surgery, either conservative management or radiosurgery should be offered. Stereotactic radiosurgery provides a noninvasive treatment of such lesions and should be considered in the discussion of management of all arteriovenous malformations. Customization of treatment strategy to each arteriovenous malformation is necessary, as obliteration rates and complications share an inverse relationship depending on treatment volume and radiation dose. This chapter presents the key considerations in the work-up and radiosurgical management of patients with arteriovenous malformations.

Prevalence of Brain Arteriovenous Malformations in First-Degree Relatives of Patients With a Brain Arteriovenous Malformation

Stroke ◽  
2014 ◽  
Vol 45 (11) ◽  
pp. 3231-3235 ◽  
Author(s):  
Janneke van Beijnum ◽  
H. Bart van der Worp ◽  
Ale Algra ◽  
W. Peter Vandertop ◽  
René van den Berg ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Brain Arteriovenous Malformation ◽  
First Degree Relatives ◽  
Brain Arteriovenous Malformations

scholarly journals Onyx extravasation during embolization of a brain arteriovenous malformation

2016 ◽  
Vol 23 (2) ◽  
pp. 200-205 ◽  
Author(s):  
Hiroyuki Ikeda ◽  
Hirotoshi Imamura ◽  
Yuji Agawa ◽  
Yukihiro Imai ◽  
Shoichi Tani ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Immunohistochemical Staining ◽  
Pathological Findings ◽  
Brain Arteriovenous Malformation ◽  
Total Resection ◽  
Pathological Analysis ◽  
Brain Avm ◽  
Cerebellar Tissue ◽  
Martin Grade ◽  
The Brain

During Onyx embolization to treat brain arteriovenous malformation (AVM), carefully observing the penetration of Onyx to the nidus is important in order to avoid complications such as hemorrhage, ischemia, and difficulty with microcatheter removal. We encountered a case of Onyx extravasation during embolization of a cerebellar AVM confirmed by surgical resection and pathological analysis. The patient was a 44-year-old man with Spetzler-Martin grade I cerebellar AVM who underwent Onyx embolization prior to resection of the brain AVM. While injecting Onyx into the nidus using the “plug-and-push” technique, Onyx extravasation was observed. Onyx injection was paused and subsequently restarted, thereby allowing continuation of embolization. An oblate Onyx cast that was entirely covered in cerebellar tissue was removed during total resection of the AVM, performed the same day. The surgically removed oblate Onyx cast did not contain brain tissue or vessel wall, and immunohistochemical staining against glial fibrillary acidic protein (GFAP) showed Onyx penetration into GFAP-positive cerebellar tissue. Onyx extravasation was confirmed based on intraoperative findings during resection as well as pathological findings. The patient has been followed for four years postoperatively, and adverse events caused by Onyx extravasation have not been observed. Unexpected cast of Onyx, remote from the vascular architecture of the AVM, may represent an intra-parenchymal extravasation.

scholarly journals Pathogenesis of non-hereditary brain arteriovenous malformation and therapeutic implications

2020 ◽  
Vol 26 (3) ◽  
pp. 244-253 ◽  
Author(s):  
Takahiro Ota ◽  
Masaki Komiyama
Keyword(s):  
High Risk ◽  
Arteriovenous Malformation ◽  
Signaling Pathways ◽  
Intracranial Hemorrhage ◽  
Arteriovenous Malformations ◽  
Genetic Factors ◽  
Angiogenic Factors ◽  
Brain Arteriovenous Malformation ◽  
Therapeutic Implications ◽  
Brain Arteriovenous Malformations

Brain arteriovenous malformations have a high risk of intracranial hemorrhage, which is a substantial cause of morbidity and mortality in patients with brain arteriovenous malformations. Although a variety of genetic factors leading to hereditary brain arteriovenous malformations have been extensively investigated, their pathogenesis is still not well elucidated, especially in sporadic brain arteriovenous malformations. The authors have reviewed the updated data of not only the genetic aspects of sporadic brain arteriovenous malformations, but also the architecture of microvasculature, the roles of the angiogenic factors, and the signaling pathways. This knowledge may allow us to infer the pathogenesis of sporadic brain arteriovenous malformations and develop pre-emptive treatments for them.

The Surgical Treatment of Arteriovenous Malformations of the Brain

1956 ◽  
Vol 13 (3) ◽  
pp. 259-270 ◽  
Author(s):  
Robert A. Hayne ◽  
Ludwig G. Kempe ◽  
William Coxe
Keyword(s):  
Surgical Treatment ◽  
Arteriovenous Malformations ◽  
The Brain

Familial occurrence of arteriovenous malformation of the brain

1991 ◽  
Vol 74 (4) ◽  
pp. 585-589 ◽  
Author(s):  
Kazutoshi Yokoyama ◽  
Yoshitaka Asano ◽  
Takatsugu Murakawa ◽  
Mitsuaki Takada ◽  
Takashi Ando ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Genetic Factors ◽  
High Rate ◽  
Familial Incidence ◽  
Brain Vessels ◽  
Content Type ◽  
Familial Cases ◽  
The Brain ◽  
Fine Print

✓ Brain arteriovenous malformations are considered to originate from a congenital maldevelopment of the brain vessels. Although there have been occasional reports suggesting a familial incidence of these lesions, data for only 10 families have been accumulated in the literature. The authors report on six such cases in three families. This high rate of occurrence of familial cases suggests an involvement of genetic factors.

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