Cerebral arteriovenous malformations; results of microsurgical management

Nornes, Helge; Lundar, Tryggve; Wikeby, Per

doi:10.1007/bf01808521

Cited by 37 publications

(15 citation statements)

References 20 publications

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“…Several large series in the literature reporting long-term surgical results in the treatment of cerebral AVMs have shown that those patients with no residual nidus or early draining veins in the postoperative angiogram do not experience rebleeding [5, 6, 7, 8, 9, 10, 11]. This is in accord with the general consensus that complete surgical removal of an AVM should eliminate the risk for an associated haemorrhage.…”

Section: Discussionsupporting

confidence: 65%

Recurrence of a Cerebral Arteriovenous Malformation after Surgical Excision

Freudenstein¹,

Duffner²,

Ernemann

et al. 2001

Cerebrovasc Dis

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Complete resection of a cerebral arteriovenous malformation (AVM) should eliminate the future risk of an associated intracranial bleeding. Because total removal of an AVM may be difficult to assess at the time of surgery, postoperative angiography has become the accepted standard for documenting that complete removal has been achieved. However, even angiographically confirmed excision of an AVM does not completely exclude the possibility of rebleeding. Regrowth of an AVM with subsequent haemorrhage has been documented in children and is attributed to forces acting on the immature vasculature. The authors report the case of a 21-year-old man whose AVM recurred 5 years after angiographically proven complete excision. According to the presented case, the authors emphasise that, even in adults, angiographic documentation of total removal does not always eliminate the risk of reformation of an AVM.

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Section: Discussionsupporting

confidence: 65%

Recurrence of a Cerebral Arteriovenous Malformation after Surgical Excision

Freudenstein¹,

Duffner²,

Ernemann

et al. 2001

Cerebrovasc Dis

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“…Numerous large studies have suggested that those patients with negative postoperative cerebral angiograms do not experience recurrences [13, 14, 15, 16, 17, 18]. For the vast majority of cases, this assumption is valid.…”

Section: Discussionmentioning

confidence: 94%

Recurrence of Pediatric Cerebral Arteriovenous Malformations after Angiographically Documented Resection

et al. 2003

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Angiographically confirmed surgical resection is believed to be the ‘gold standard’ for cure in the treatment of intracranial arteriovenous malformations (AVMs). However, rare exceptions of recurrent AVMs have been documented. We are aware of 11 reported cases of recurrent AVMs in which complete resection of the initial lesion was confirmed by postoperative angiography. Eight of these cases were in the pediatric population. In this report, we present 2 additional cases of such recurrent lesions, review the clinical and scientific literature on this rare phenomenon and provide suggested management guidelines.

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“…It is clinically well known that an AVM may be partly and temporarily inactive in the acute or subacute stage of hemorrhage. 19 Computerized tomography in three of the patients with recent AVM hemorrhage showed intracerebral hematoma of varying size. In the fourth patient, whose CT scans revealed clots in the basal cisterns and ventricles, flow velocities in the MCA remote from the AVM increased from 81 to 158 cm/sec between Days 3 and 9.…”

Section: A Vm Hemorrhagementioning

confidence: 98%

Evaluation of cerebral AVM's using transcranial Doppler ultrasound

Lindegaard¹,

Grolimund²,

Aaslid³

et al. 1986

Journal of Neurosurgery

164

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Blood flow velocities in basal cerebral arteries were recorded noninvasively in 28 patients with cerebral arteriovenous malformations (AVM's) and were correlated with the angiographic findings. In normal arteries remote from the AVM, flow velocities ranged from 44 to 94 cm/sec (median 65 cm/sec) with pulsatility indexes from 0.65 to 1.10 (median 0.87). This is consistent with findings in normal individuals. Arteries feeding the AVM's were identified by the high flow velocities (ranging from 75 to 237 cm/sec, median 124 cm/sec). The pulsatility index ranged from 0.22 to 0.74 (median 0.48). The difference of these results from findings in normal remote arteries was highly significant (p less than 0.001). Hyperventilation tests illustrated the hemodynamic difference between an AVM and normal cerebrovascular beds. Flow velocity measurements permitted noninvasive diagnosis of AVM's in 26 of the 28 patients. Furthermore, the identification of individual feeding arteries permitted good definition of the anatomical localization of individual AVM's. Flow velocity measurements combined with computerized tomography scans are useful in the diagnosis of AVM's. With the feeding artery's configuration identified on angiography, flow velocity measurements permit a new insight into the "hemodynamic dimension" of an AVM and its possible effects on adjacent normal brain-tissue perfusion in the individual patient.

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Cerebral arteriovenous malformations; results of microsurgical management

Cited by 37 publications

References 20 publications

Recurrence of a Cerebral Arteriovenous Malformation after Surgical Excision

Recurrence of a Cerebral Arteriovenous Malformation after Surgical Excision

Recurrence of Pediatric Cerebral Arteriovenous Malformations after Angiographically Documented Resection

Evaluation of cerebral AVM's using transcranial Doppler ultrasound

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