Medial occipital arteriovenous malformations

1982 ◽  
Vol 56 (6) ◽  
pp. 798-802 ◽  
Author(s):  
Neil A. Martin ◽  
Charles B. Wilson
Keyword(s):  
Visual Field ◽  
Arteriovenous Malformations ◽  
Posterior Cerebral Artery ◽  
Occipital Region ◽  
Intracranial Arteriovenous Malformations ◽  
Content Type ◽  
Visual Field Deficit ◽  
History Of ◽  
Migrainous Headache ◽  
Fine Print

✓ In a consecutive operative series of 115 intracranial arteriovenous malformations (AVM's), 16 occupied the medial occipital region. Typically, the patients with medial occipital AVM's presented with bleeding, often accompanied by homonymous visual field deficit, or with migrainous headache. The malformations were supplied principally by branches of the posterior cerebral artery. Through an occipital craniotomy, a surgical approach along the junction of the falx and tentorium provided access to the arteries feeding the AVM and facilitated excision of the malformation. There were no deaths in the series. The incidence of visual field deficit after the operation varied, but in only five cases was the visual field worsened postoperatively. All patients who had a history of intractable headache were cured or improved after surgery. These lesions are favorably situated for surgical treatment.

Optic nerve ganglioglioma

1993 ◽  
Vol 78 (6) ◽  
pp. 979-982 ◽  
Author(s):  
William Y. Lu ◽  
Marc Goldman ◽  
Byron Young ◽  
Daron G. Davis
Keyword(s):  
Magnetic Resonance Imaging ◽  
Nervous System ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Visual Field ◽  
Resonance Imaging ◽  
Optic Nerve Glioma ◽  
Content Type ◽  
Visual Field Deficit ◽  
Fine Print

✓ Gangliogliomas of the optic nerve are extremely rare. The case is reported of a 38-year-old man who presented with a visual field deficit and was discovered to have an optic nerve ganglioglioma. The possible embryological origins of this neoplasm, its histological and immunohistochemical features, and its appearance on magnetic resonance imaging are examined. The prognoses of optic nerve glioma and of gangliogliomas occurring elsewhere in the nervous system are compared.

Tuberculous brain abscess

1980 ◽  
Vol 52 (3) ◽  
pp. 419-422 ◽  
Author(s):  
P. R. Mata González ◽  
Carlos Vázquez Herrero ◽  
G. Flambert Joachim ◽  
C. Ruiz Ocaña ◽  
G. Cobo Sevilla ◽  
...  
Keyword(s):  
Brain Abscess ◽  
Tuberculous Meningitis ◽  
Previous History ◽  
Miliary Tuberculosis ◽  
Occipital Region ◽  
Content Type ◽  
Tuberculous Abscess ◽  
History Of ◽  
Tuberculous Brain Abscess ◽  
Fine Print

✓ An abscess was removed from the left occipital region in a 73-year-old woman with no previous history of tuberculosis. The patient later died from aspiration bronchopneumonia. Autopsy revealed a basilar tuberculous meningitis and miliary tuberculosis in the peritracheal lymphatic glands, the liver, the spleen, and in isolated areas of the lungs. No chronic tuberculous foci were noted in any area. Including this case, only 18 instances of tuberculous abscess have been reported.

Analysis of the causes of treatment failure in gamma knife radiosurgery for intracranial arteriovenous malformations

2000 ◽  
Vol 93 (supplement_3) ◽  
pp. 104-106 ◽  
Author(s):  
Yang Kwon ◽  
Sang Ryong Jeon ◽  
Jeong Hoon Kim ◽  
Jung Kyo Lee ◽  
Dong Sook Ra ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Treatment Failure ◽  
Gamma Knife ◽  
Arteriovenous Malformations ◽  
Gamma Knife Radiosurgery ◽  
Intracranial Arteriovenous Malformations ◽  
Content Type ◽  
The Mean ◽  
Fine Print

Object. The authors sought to analyze causes for treatment failure following gamma knife radiosurgery (GKS) for intracranial arteriovenous malformations (AVMs), in cases in which the nidus could still be observed on angiography 3 years postsurgery. Methods. Four hundred fifteen patients with AVMs were treated with GKS between April 1990 and March 2000. The mean margin dose was 23.6 Gy (range 10–25 Gy), and the mean nidus volume was 5.3 cm3 (range 0.4–41.7 cm3). The KULA treatment planning system and conventional subtraction angiography were used in treatment planning. One hundred twenty-three of these 415 patients underwent follow-up angiography after GKS. After 3 years the nidus was totally obliterated in 98 patients (80%) and partial obliteration was noted in the remaining 25. There were several reasons why complete obliteration was not achieved in all cases: inadequate nidus definition in four patients, changes in the size and location of the nidus in five patients due to recanalization after embolization or reexpansion after hematoma reabsorption, a large AVM volume in five patients, a suboptimal radiation dose to the thalamic and basal ganglia in eight patients, and radioresistance in three patients with an intranidal fistula. Conclusions. The causes of failed GKS for treatment of AVMs seen on 3-year follow-up angiograms include inadequate nidus definition, large nidus volume, suboptimal radiation dose, recanalization/reexpansion, and radioresistance associated with an intranidal fistula.

Dural arteriovenous malformation of the skull base with intraosseous vascular nidus

1994 ◽  
Vol 81 (4) ◽  
pp. 620-623 ◽  
Author(s):  
Ghaus M. Malik ◽  
Asim Mahmood ◽  
Bharat A. Mehta
Keyword(s):  
Arteriovenous Malformation ◽  
Skull Base ◽  
Arteriovenous Malformations ◽  
Venous Drainage ◽  
Dural Arteriovenous Malformation ◽  
Intracranial Arteriovenous Malformations ◽  
Content Type ◽  
Small Subgroup ◽  
Fine Print ◽  
Dural Venous Sinuses

✓ Intracranial arteriovenous malformations (AVM's) have been classified as pure pial, pure dural, and mixed pial and dural. Dural AVM's are relatively uncommon, with 377 cases documented up to 1990. These lesions were believed to be situated within the walls of the sinuses, but during the last decade researchers discovered a small subgroup of dural AVM's in extrasinusal locations such as the skull base and tentorium. Two of the 17 patients who were studied between 1976 and 1993 had dural AVM's that were entirely intraosseous except for their venous drainage, which was via the dural venous sinuses. Although such intraosseous dural AVM's have not been previously described, the authors elected to group these malformations with dural AVM's because their venous drainage was intracranial and angiograms revealed identical features.

Multiple cerebral arteriovenous malformations associated with soft-tissue vascular malformations

1981 ◽  
Vol 54 (5) ◽  
pp. 670-672 ◽  
Author(s):  
Ahmed Hanieh ◽  
Peter C. Blumbergs ◽  
Paul G. Carney
Keyword(s):  
Soft Tissue ◽  
Arteriovenous Malformations ◽  
Vascular Malformations ◽  
Rare Condition ◽  
Cerebral Arteriovenous Malformations ◽  
Intracranial Arteriovenous Malformations ◽  
Content Type ◽  
Fine Print

✓ A patient found unconscious, probably due to a seizure, was discovered to have two intracranial arteriovenous malformations. Multiple arteriovenous malformations is a rare condition, and both lesions were excised successfully.

Treatment and outcome in 30 patients with posterior cerebral artery aneurysms

2003 ◽  
Vol 99 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Christopher L. Taylor ◽  
Thomas A. Kopitnik ◽  
Duke S. Samson ◽  
Phillip D. Purdy
Keyword(s):  
Visual Field ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Underlying Disease ◽  
Neurological Deficits ◽  
Content Type ◽  
Ruptured Aneurysms ◽  
The Mean ◽  
Poor Outcomes ◽  
Fine Print

Object. The records of 30 patients with posterior cerebral artery (PCA) aneurysms treated during a 12-year period were reviewed to determine outcome and the risk of visual field deficit associated with PCA sacrifice. Methods. Clinical data and treatment summaries for all patients were maintained in an electronic database. The Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS) scores were determined by an independent registrar. Visual field changes were determined by review of medical records. Twenty-eight patients were treated with open surgery, one of them after an attempt at detachable coil embolization failed. Two patients underwent successful endovascular PCA sacrifice. The mean GOS and mRS scores in 18 patients with unruptured aneurysms were 4 and 2, respectively, at discharge. Subarachnoid hemorrhage (SAH) from other aneurysms and neurological deficits caused by the PCA lesion or underlying disease contributed to poor outcomes in this group. The mean GOS and mRS scores in 12 patients with ruptured aneurysms were 4 and 4, respectively, at discharge. One patient died of severe vasospasm. Neurological deficits secondary to SAH and, in one patient, treatment of a concomitant arteriovenous malformation contributed to poor outcomes in the patients with ruptured aneurysms. Seven patients with normal visual function preoperatively underwent PCA occlusion. One patient (14%) developed a new visual field deficit. Conclusions. Optimal treatment of PCA aneurysms is performed via one of several surgical approaches or by endovascular therapy. The approach is determined, in part, by the anatomical location and size of the aneurysm and the presence of underlying disease and neurological deficits.

The natural history of aneurysms and arteriovenous malformations

1985 ◽  
Vol 62 (3) ◽  
pp. 321-323 ◽  
Author(s):  
John A. Jane ◽  
Neal F. Kassell ◽  
James C. Torner ◽  
H. Richard Winn
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Natural History ◽  
Arteriovenous Malformations ◽  
Anterior Cerebral Artery ◽  
Unknown Etiology ◽  
Content Type ◽  
Ruptured Aneurysms ◽  
History Of ◽  
Fine Print

✓ The authors summarize the findings of previous studies relating to the natural history of aneurysms and arteriovenous malformations (AVM's). Ruptured aneurysms have their highest rate of rebleeding on Day 1, and at least 50% will rebleed during the 6 months after the first hemorrhage. Thereafter, the rate drops to at least 3% a year. This is the same rate as seen in anterior and posterior communicating artery aneurysms treated by anterior cerebral artery clipping and carotid ligation; these operations provide immediate protection but do not result in long-term diminution of the risk of rebleeding. Patients with unruptured incidental and unruptured multiple aneurysms rebleed at a rate of 1% per year, as do patients with subarachnoid hemorrhage of unknown etiology. The risk of rebleeding for AVM's is 3% a year.

Microsurgery for 67 intracranial arteriovenous malformations less than 3 cm in diameter

1993 ◽  
Vol 79 (5) ◽  
pp. 653-660 ◽  
Author(s):  
Michael B. Sisti ◽  
Abraham Kader ◽  
Bennett M. Stein
Keyword(s):  
Arteriovenous Malformations ◽  
Operative Mortality ◽  
Surgical Results ◽  
Cure Rate ◽  
Intracranial Arteriovenous Malformations ◽  
Surgical Morbidity ◽  
Content Type ◽  
Microsurgical Technique ◽  
Neurological Morbidity ◽  
Fine Print

✓ The surgical outcome in a series of small arteriovenous malformations (AVM's) that might have been considered optimal for radiosurgery is reviewed. In a total microsurgical series of 360 patients, 67 (19%) underwent resection of AVM's less than 3 cm in largest diameter, regardless of location. Many of these lesions (45%) were in locations that might be considered surgically inaccessible such as the thalamus, brain stem, medial hemisphere, and paraventricular regions. Complete angiographic obliteration of the AVM by microsurgical technique was accomplished in 63 patients (94%) with a surgical morbidity of 1.5% and no operative mortality. Patients with hemispheric AVM's had a cure rate of 100% and no neurological morbidity. Stereotactically guided craniotomy was used in 14 patients (21%) to locate and resect deep or concealed malformations. The results from five major radiosurgery centers treating similar-sized AVM's are analyzed. The authors' surgical results compare favorably with those from radiosurgery centers which, in their opinion, supports the conclusion that microneurosurgery is superior to radiosurgery, except for a small percentage of lesions that are truly inoperable on the basis of inaccessibility.

The natural history of symptomatic arteriovenous malformations of the brain: a 24-year follow-up assessment

1990 ◽  
Vol 73 (3) ◽  
pp. 387-391 ◽  
Author(s):  
Stephen L. Ondra ◽  
Henry Troupp ◽  
Eugene D. George ◽  
Karen Schwab
Keyword(s):  
Mortality Rate ◽  
Arteriovenous Malformations ◽  
Original Population ◽  
Major Morbidity ◽  
Content Type ◽  
History Of ◽  
The Mean ◽  
The Brain ◽  
Fine Print

✓ The authors have updated a series of 166 prospectively followed unoperated symptomatic patients with arteriovenous malformations (AVM's) of the brain. Follow-up data were obtained for 160 (96%) of the original population, with a mean follow-up period of 23.7 years. The rate of major rebleeding was 4.0% per year, and the mortality rate was 1.0% per year. At follow-up review, 23% of the series were dead from AVM hemorrhage. The combined rate of major morbidity and mortality was 2.7% per year. These annual rates remained essentially constant over the entire period of the study. There was no difference in the incidence of rebleeding or death regardless of presentation with or without evidence of hemorrhage. The mean interval between initial presentation and subsequent hemorrhage was 7.7 years.

Arteriovenous malformations of the medial temporal lobe

1982 ◽  
Vol 56 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Roberto C. Heros
Keyword(s):  
Basal Ganglia ◽  
Temporal Lobe ◽  
Cerebral Artery ◽  
Medial Temporal Lobe ◽  
Arteriovenous Malformations ◽  
Posterior Cerebral Artery ◽  
Internal Capsule ◽  
Content Type ◽  
Inferior Portion ◽  
Fine Print

✓ Arteriovenous malformations (AVM's) of the medial temporal lobe frequently involve the basal ganglia and the thalamus and, for this reason, are commonly judged to be inoperable. However, when the medial involvement is limited to the posterolateral part of the thalamus and to the inferior portion of the basal ganglia lateral to the internal capsule, the lesions may be excised safely. Three patients who underwent successful excision of AVM's of this region are presented. A transcortical surgical approach through the inferior portion of the temporal lobe was used to minimize retraction of the temporal lobe and damage to the optic radiation, and to avoid postoperative dysphasia. The following neuroradiological criteria indicate that the bulk of the lesion is in the temporal lobe, that only noncritical portions of the basal ganglia and thalamus are involved, and that, therefore, surgical resection is relatively safe: 1) primary supply by the anterior choroidal artery and by laterally oriented branches of the posterior cerebral artery; 2) primary venous drainage into the basal vein of Rosenthal and medial Sylvian veins; 3) projection below the plane of the middle cerebral artery in the lateral carotid arteriogram; 4) projection lateral to the sweep of the posterior cerebral artery in the anteroposterior or Towne's view of the vertebral angiogram; and 5) demonstration of an intratemporal clot or intraventricular blood by computerized tomography.

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