scholarly journals PENDARAHAN BERULANG SETELAH 14 TAHUN PADA MALFORMASI ARTERIOVENA DI SEREBELARIS

2018 ◽  
Vol 35 (4) ◽  
Author(s):  
Ni Nyoman Ayu Trisnadewi ◽  
Kumara Tini
Keyword(s):  
Arteriovenous Malformation ◽  
Ct Scan ◽  
Digital Subtraction Angiography ◽  
High Flow ◽  
Superior Cerebellar Artery ◽  
Recurrent Bleeding ◽  
Digital Subtraction ◽  
Feeding Artery ◽  
Cerebellar Artery ◽  
Superior Petrosal Vein

  THE LATE ONSET RE-BLEEDING AFTER 14 YEARS OF RUPTURE CEREBELLAR AVMABSTRACTThe arteriovenous malformation (AVM), a form of abnormality in brain vascularization, in the cerebellum is a rare disorder. The risk of recurrent bleeding after initial episode at five years is very low about 3,67%. We reported a case of 25 years-old man with history of recurrent bleeding after 14 years with hydrocephalus as complication. The brain CT scan showed a bleeding in the cerebellar vermis  with non-communicant hydrocephalus. The Digital Subtraction Angiography (DSA) showed a moderate left cerebellar AVM with high-flow plexiform nidus, left superior cerebellar artery as primary feeding artery with supplementary supply of the vein draining from the superior cerebellar artery to superior petrosal vein leading to the superior petrosal vein toward the contralateral transverse sinus and left sigmoid sinus. Embolization for infratentorial posterior fossa AVM bleeding needs to be considered even though previous bleeding occurs over 5 years to prevent re-bleeding.Keywords: Arteriovenous malformation, embolization, feeding artery, nidusABSTRAKKelainan pembuluh darah malformasi arteriovena (MAV) pada serebelum merupakan kelainan vaskular yang jarang terjadi. Risiko pendarahan berulang setelah tahun kelima adalah rendah sekitar 3,67%. Dilaporkan suatu kasus laki-laki, 25 tahun, dengan riwayat pendarahan serebri berulang setelah 14 tahun dengan komplikasi hidrosefalus. CT scan kepala menunjukkan adanya pendarahan pada bagian vermis dengan hidrosefalus non-komunikan. Pemeriksaan DSA (digital subtraction angiography) menunjukkan adanya MAV fosa posterior di serebelum kiri ukuran sedang dengan nidus pleksiformis high flow dan feeder utama arteri serebelaris superior kiri ke vena petrosal superior menuju ke sinus transversus kontralateral dan sinus sigmoid kiri. Tata laksana embolisasi pada MAV infratentorial fosa posterior yang mengalami pendarahan perlu dipertimbangkan walaupun pendarahan sebelumnya terjadi lebih dari 5 tahun untuk mencegah pendarahan kembali.Kata kunci: Embolisasi, feeding arteri, malformasi arteriovena, nidus 

Detection of Predictors of Hemorrhage in Patients with Cerebral Arteriovenous Malformation by Digital Subtraction Angiography

2019 ◽  
Vol 8 (2) ◽  
pp. 87-92
Author(s):  
Fazlul Haque ◽  
Shariful Islam ◽  
Monzurul Haque ◽  
Shafiul Alam ◽  
Raziul Haque
Keyword(s):  
Arteriovenous Malformation ◽  
Digital Subtraction Angiography ◽  
Venous Drainage ◽  
High Flow ◽  
Cerebral Arteriovenous Malformation ◽  
P Value ◽  
Digital Subtraction ◽  
College Hospital ◽  
Multiple Imaging ◽  
Arterial Feeder

Background: Cerebral arteriovenous malformation (AVM) is a complex tangled of dilated blood vessels in which arteries flow directly into veins without capillaries. The main cause of death in patients with cerebral AVM is intraparenchymal hemorrhage. There are multiple imaging tools that can detect the predictors of hemorrhage in cerebralarteriovenous malformation. But nowadays digital subtraction angiography (DSA) is playing a wonderful role to detect these predictors. Objectives: To detect the common predicting factors of hemorrhage from in brain by DSA. Methodology:This observational cross-sectional study was carried out in the department of Neurosurgery, Dhaka Medical College Hospital and study period was from October, 2014 to March, 2016. 76 patients of hemorrhagic stroke with clinical and radiological (CT scan) suspicion of ruptured cerebral AVM were selected by non-probability purposive sampling technique. After that enrolled patients were scrutinized according to selection criteria. Finally selected 50 patients who underwent DSA and were positive for AVM were included in this study. All the included patients’ demographic, clinical and DSA profile were recorded in pre-structured data collection sheet. All the data were compiled, edited and plotted in tabular and figure forms. Data analysis was done by chi-square test. P value was determined significant when it was <0.05. Results: In angiographic presentation, maximum cases were found deep seated (72%), small sized (<3 cm) (70%), having compact type of nidus (58%), having superficial arterial feeder (62%), having high flow draining vein (70%), having deep venous drainage (56%) and single draining vein (78%). Associated aneurysm and venous ectasia were 12% and 4% respectively. The statistically significant predictors were deep location (P=0.036) and superficial arterial feeder (P=0.03) between male and female subjects. Conclusion: Our results showed that small sized, deep-seated Cerebral arteriovenous malformation, having high flow draining vein, having deep venous drainage and single number of draining vein are the possible causes of hemorrhage. Lesions that have associated aneurysms have a risk of bleeding. Bang. J Neurosurgery 2019; 8(2): 87-92

scholarly journals Signal intensity ratio of draining vein on silent MR angiography as an indicator of high-flow arteriovenous shunt in brain arteriovenous malformation

2021 ◽  
Author(s):  
Chun-Xue Wu ◽  
Zhen-Xiang Zang ◽  
Tao Hong ◽  
Meng-Qi Dong ◽  
Yi Shan ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Digital Subtraction Angiography ◽  
Transit Time ◽  
Signal Intensity ◽  
Intensity Ratio ◽  
Mr Angiography ◽  
High Flow ◽  
Signal Intensity Ratio ◽  
Digital Subtraction ◽  
Brain Arteriovenous Malformation

Abstract Objectives To evaluate whether the signal intensity ratio (rSI) of the draining vein on silent MR angiography is correlated with arteriovenous (A–V) transit time on digital subtraction angiography (DSA), thereby identifying high-flow A–V shunt in brain arteriovenous malformation (BAVM), and to analyze whether the rSI and the characteristic of draining veins on silent MRA are associated with hemorrhage presentation. Methods Eighty-one draining veins of 46 participants with BAVM (mean age 33.2 ± 16.9 years) who underwent silent MRA and DSA were evaluated retrospectively. The correlation between the rSI of the draining vein on silent MRA and A–V transit time on DSA was examined. The AUC-ROC was obtained to evaluate the performance of the rSI in determining the presence of high-flow A–V shunt. The characteristics of draining veins with the maximum rSI (rSImax) were further compared between the hemorrhagic and non-hemorrhagic untreated BAVM. Results The rSI of each draining vein on silent MRA was significantly correlated with A–V transit time from DSA (r = −0.81, p < .001). The AUC-ROC was 0.89 for using the rSI to determine the presence of high-flow A–V shunt. A cut-off rSI value of 1.09 yielded a sensitivity of 82.4% and a specificity of 82.8%. The draining vein with rSImax and no ectasia was significantly more observed in the hemorrhagic group (p = 0.045). Conclusions The rSI of the draining vein on silent MRA is significantly correlated with A–V transit time on DSA, and it can be used as an indicator of high-flow A–V shunt in BAVM. Key Points • The signal intensity ratio (rSI) of the draining vein on silent MRA significantly correlated with arteriovenous (A–V) transit time of brain arteriovenous malformation (BAVM) on digital subtraction angiography (DSA). • The area under the receiver operating characteristic curve (AUC) was 0.89 for using the rSI of draining veins to determine high-flow A–V shunt. • Draining veins with maximum rSI and no ectasia were significantly more observed in the hemorrhagic group of BAVM (p = 0.045).

A Microguide Wire with a Scale (Scaler Guide)

1997 ◽  
Vol 3 (2_suppl) ◽  
pp. 212-214
Author(s):  
S. Nishi ◽  
N. Hashimoto ◽  
T. Todaka ◽  
A. Nomura
Keyword(s):  
Arteriovenous Malformation ◽  
Digital Subtraction Angiography ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Digital Subtraction ◽  
Stenotic Lesion ◽  
Magnification Ratio ◽  
Percutaneous Transluminal ◽  
Selection Of

There are various methods for measuring an affected vascular size during embolization or percutaneous transluminal angioplasty (PTA). Metallic balls, electrodes, grids, coins on the skin were simple and useful in this sense, but not stable and exact for measuring. A 0.014 “or 0.016” microguide wire with 5 gold markers in the tip is newly developed and used clinically (a scaler guide). One marker measures 1 mm in length. There is a distance of 4 mm between two neighboring markers. A microcatheter is navigated using a standard microguide wire into the vessels of the lesion. Bilateral digital subtraction angiography (DSA) is performed after exchange of a microguide wire with a scaler guide. Magnification ratio between distance measured by DSA and real distance from markers is calculated. Thereafter, the size of the vessels will be measured. With this method, the size of vessels was measured in patients with aneurysm or arteriovenous malformation or stenotic lesion. Selection of coils or PTA balloons could be made easily and effectively. Interventions were more safely performed with this new scaler guide.

scholarly journals Clinical and Radiation Diagnosisof Renal Arteriovenous Malformation

2017 ◽  
pp. 53-61
Author(s):  
A. N. Askerova
Keyword(s):  
Arteriovenous Malformation ◽  
Digital Subtraction Angiography ◽  
Arteriovenous Malformations ◽  
Multidetector Ct ◽  
Accurate Information ◽  
Digital Subtraction ◽  
Ct Scanner ◽  
Medical Systems ◽  
Iodinated Contrast ◽  
Renal Arteriovenous Malformation

Purpose:to analyze the results of preoperative diagnosis and treatment of patients with renal arteriovenous malformation and compare them with the literature data.Materials and methods.5 patients with renal arteriovenous malformations were examined for the period from 2014 to2016 in the FSBI "A.V. Vishnevsky Institute of Surgery» MH RF, where simultaneously there are clinical departments of urology and vascular surgery, 4 of them were treated. All patients were female. The mean age was 31.8 ± 6.7 years (24–41 years). Ultrasound was done to all the patients in B-mode followed by a duplex scan using an abdominal 2–4 MHz convex. MDCT was performed in 4 patients out of 5. Patients underwent multiphase examination on a multidetector CT-scanner Philips Brilliance iCT-256 and Brilliance CT-64 (Philips Medical Systems (Cleveland) with the 120 kV and 100 kV protocols and an intravenous injection of the iodinated contrast agent. Digital subtraction angiography was performed in 3 patients.Results.One-sided lesion occurred in four cases (3 of them (60%) right-sided and 1 (20%) left-sided), in one patient (20%) arteriovenous malformation was bilateral As a result of the analysis of our own material and literature data, the diagnostic criteria of renal arteriovenous malformations according to ultrasound, MDCT and digital subtraction angiography were studied in detail. The results of the examinations of 5 patients with demonstration of ultrasound, MDCT and angiographic images are presented with the visualization of the characteristic features of renal AVM. In addition, the treatment options for such patients with the possibility of preserving the kidney are described.Conclusion.Duplex scanning is an effective method of diagnosis and postoperative follow-up of patients with renal arteriovenous malformations. Preoperative computed tomography and selective digital subtraction angiography provide accurate information about the renal angioarchitectonics and AV-shunts for choosing the treatment tactics and planning the surgical intervention. 

scholarly journals Acute surgery for a case of superior vermian arteriovenous malformation producing raised venous pressure coexisting with basilar-superior cerebellar artery aneurysm presenting subarachnoid hemorrhage; Case report

2021 ◽  
Vol 12 ◽  
pp. 23
Author(s):  
Sho Tsunoda ◽  
Tomohiro Inoue ◽  
Akihiro Shimoi ◽  
Atsuya Akabane
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Arteriovenous Malformation ◽  
Cerebral Vasospasm ◽  
Acute Phase ◽  
Venous Pressure ◽  
Artery Aneurysm ◽  
Superior Cerebellar Artery ◽  
Oculomotor Palsy ◽  
Acute Surgery ◽  
Cerebellar Artery

Background: Superior vermian subtype of arteriovenous malformation (AVM) coexisting with proximal feeder aneurysm on basilar-superior cerebellar artery (BA-SCA) junction is an extremely rare situation. We experienced a case of this rare entity presenting with subarachnoid hemorrhage (SAH), and herein, introduce the outline and clinical features of this experience together with the actual surgical video. Case Description: A 54-year-old man SAH patient with severe headache, disturbance of consciousness, and left oculomotor palsy was urgently admitted to our hospital. Imaging examination demonstrated superior vermian AVM with BA-SCA aneurysm, and both lesions were treated through two different approaches (left pterional craniotomy in conjunction with zygomectomy, and left posterior interhemispheric occipital transtentorial approach) in acute phase of SAH. Both lesions were completely disappeared postoperatively and the patient’s postoperative course was favorable, without symptomatic cerebral vasospasm. Although slight oculomotor palsy remained, the patient recovered well and was transferred to a rehabilitation hospital for further improvement. Conclusion: In the cases of AVM coexisting with proximal feeder aneurysm, presenting with SAH, disorders of intracranial venous return associated with an AVM can be a vital hindrance to managing cerebral vasospasm; therefore, treating both lesions in the acute phase may lead to good outcomes.

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