scholarly journals Galvos smegenų arterioveninės malformacijos

2009 ◽  
Vol 7 (3-4) ◽  
pp. 0-0
Author(s):  
Irena Bičkutė ◽  
Mindaugas Avižonis
Keyword(s):  
Arteriovenous Malformation ◽  
Vascular Disease ◽  
Key Words ◽  
Arteriovenous Malformations ◽  
Regional Hospital ◽  
Capillary Network ◽  
Physiological Changes ◽  
Brain Avm ◽  
Life Threatening ◽  
The Brain

Irena Bičkutė1, Mindaugas Avižonis21 Švenčionių rajono ligoninė, Partizanų g. 4, LT-18126 Švenčionys2 Mykolo Marcinkevičiaus ligoninė, Kauno g. 7/2, LT-03215 VilniusEl paštas: [email protected] Galvos smegenų arterioveninė malformacija (AVM) – įgimta smegenų patologija, kuriai būdingos patologinės arterijų ir venų jungtys, kuriomis arterinis kraujas patenka į smegenų venas, aplenkdamas normalų kapiliarų tinklą. Ši patologija reta, tačiau sukelia daug anatominių ir fiziologinių pokyčių, kelia pavojų gyvybei. Straipsnyje trumpai aprašoma AVM paplitimas, kilmė, patologija, klinika, diagnostika ir gydymas. Reikšminiai žodžiai: galvos smegenų arterioveninė malformacija, etiologija, epidemiologija, klinika, diagnostika, gydymas. Arteriovenous malformations of the brain Irena Bičkutė1, Mindaugas Avižonis21 The Švenčioniai Regional Hospital, Partizanų g. 4, LT-18126 Švenčionys, Lithuania2 The Mykolas Marcinkevičius Hospital, Kauno str. 7/2, LT-03215 Vilnius, LithuaniaE-mail: [email protected] Arteriovenous malformation (AVM) of the brain is a congenital vascular disease and has three morphologic components: the dysplastic vascular nidus, the feeding arteries, and the draining veins. The underlying lesion appears to represent a perpetuation of primitive arteriovenous communications which normally should be replaced by an intervening capillary network. AVM is potentially life-threatening and causes many anatomical and physiological changes. This article contains a description of epidemiology, etiology, pathology, clinic, diagnostics and treatment of brain AVM. Key words: arteriovenous malformation of the brain, etiology, epidemiology, clinic, diagnostics, treatment

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.

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 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.

scholarly journals A theory for polymicrogyria and brain arteriovenous malformations in HHT

Neurology ◽  
2018 ◽  
Vol 92 (1) ◽  
pp. 34-42 ◽  
Author(s):  
Jesse M. Klostranec ◽  
Long Chen ◽  
Shobhit Mathur ◽  
Jamie McDonald ◽  
Marie E. Faughnan ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Fluid Shear Stress ◽  
Transmembrane Protein ◽  
Dominant Negative ◽  
Spatial Proximity ◽  
Imaging Data ◽  
Fluid Shear ◽  
Brain Avm ◽  
Close Spatial Proximity ◽  
The Brain

Hereditary hemorrhagic telangiectasia (HHT) is generally considered a disorder of endothelial dysfunction, characterized by the development of multiple systemic arteriovenous malformations (AVMs), including within the brain. However, there have recently been a number of reports correlating HHT with malformations of cortical development, of which polymicrogyria is the most common type. Here we present 7 new cases demonstrating polymicrogyria in HHT, 6 of which demonstrate a brain AVM (bAVM) in close spatial proximity, with the aim of providing a common origin for the association. Upon reviewing patient genetics and imaging data and comparing with previously reported findings, we form 2 new conclusions: (1) polymicrogyria in HHT appears exclusively associated with a subset of mutations in the transmembrane protein endoglin that is involved with blood flow–related mechanotransduction signaling during angiogenesis and (2) the polymicrogyria is characteristically unilateral, typically focal, and correlates with vascular regions experiencing low fluid shear stress during corticogenesis in utero. Integrating these with findings in the literature from genetics and molecular biology experiments, we propose a theory suggesting haploinsufficient endoglin mutations, especially those that are dominant-negative, may predispose focal, aberrant hypersprouting angiogenesis during corticogenesis that leads to the production of polymicrogyria. This hypoxic insult may further serve as the revealing trigger for later development of a spatially coincident bAVM. This hypothesis suggests an essential role for endoglin-mediated hemodynamic mechanotransduction in normal corticogenesis.

Abstract 125: Increased Endothelial Endoglin Gene Deletion and Co-deletion of EphrinB2 Enhance Brain Arteriovenous Malformation in Mice

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Rui Zhang ◽  
Wan Zhu ◽  
Li Ma ◽  
Man Luo ◽  
Lei Zhan ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Growth Factor ◽  
Arteriovenous Malformation ◽  
Gene Deletion ◽  
Viral Vector ◽  
Causative Gene ◽  
Adult Mice ◽  
Brain Avm ◽  
Endothelial Growth Factor ◽  
The Brain

Introduction: Endoglin (Eng) is an arteriovenous malformation (AVM) causative gene. In adult mice, global Eng deletion induced by a wild-type cre (cre) results in AVM formation in the brain angiogenic region. We hypothesize that using a codon-improved cre (icre) to increase Eng gene deletion in endothelial cells and co-deletion of the EphrinB2 gene, a determinant of arterial endothelial differentiation, will enhance brain AVM severity. Methods: Eng was globally deleted in adult Eng -floxed mice ( Eng 2f/2f ) using a rosa promoter driving estrogen inducible cre (Rosa-creER), or in endothelial cells using a platelet-derived growth factor b promoter driving estrogen inducible icre ( pdgfb- icreER). Pdgfb- icreER was also used to mediate endothelial deletion of EphrinB2 . An adeno-associated viral vector expressing vascular endothelial growth factor was injected into the brain to induce brain angiogenesis. Results: Compared with Rosa-CreER-mediated global Eng deletion, pdgfb- icreER-induced endothelial Eng deletion did not increase the number of abnormal vessels (P=0.39), but reduced vascular smooth muscle coverage (P=0.03) and increased hemorrhage (P=0.04) in the brain AVM lesion. Additional endothelial deletion of EphrinB2 gene increased the number of abnormal vessels in the brain (P=0.08). Conclusion: These data indicate that a positive correlation exists between the degree of gene mutation in the endothelial cells and brain AVM severity, and that dysregulation of endothelial arteriovenous specification enhances AVM formation and progression.

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.

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.

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.

scholarly journals ARTERIOVENOUS MALFORMATIONS OF THE BRAIN: ACHIEVEMENTS, ANALYSIS OF DIAGNOSIS AND TACTICS OF SURGICAL TREATMENT IN THE CONDITIONS OF THE REPUBLICAN RESEARCH CENTER OF EMERGENCY MEDICAL CARE (20-YEAR OF THE CLINIC EXPERIENCE)

2022 ◽  
Vol 14 (4) ◽  
Author(s):  
A.M. KHADJIBAEV ◽  
K.E. MAKHKAMOV ◽  
M.K. MAKHKAMOV ◽  
A.B. SALAEV ◽  
D.U. ISRAILOV ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Endovascular Embolization ◽  
Research Center ◽  
Emergency Medical Care ◽  
Brain Avm ◽  
Clinic Experience ◽  
The Brain ◽  
Combined Technique ◽  
Grade Iii

Aim. To assess the results of the activities of the neurosurgical service of the Republican Research Center of Emergency Medicine (RRCEM) over a twenty-year period of operation with an analysis of the results of neurosurgical care for patients with arteriovenous malformations of the brain (AVM). Material and Methods. The analysis was carried out of 54 patients examined and operated on for AVM, in the period from 2001 to 2020, who were treated at the Department of Adult Neurosurgery of the RRCEM. Results. The basis of our principle of a differentiated surgical approach in the treatment of AVM is the determination of the AVM grading according to the Spetzler-Martin and Lawton-Young scales. Limiting only microsurgical AVM resection is advisable for AVMs – I and II grades according to the Spetzler-Martin and Lawton-Young scales. For patients with high grades of AVMs – grade III and more, it is more expedient to use a combined technique, and with deeply located AVMs, endovascular embolization.

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