Intraoperative Sonography of Intracranial Arteriovenous Malformations

Griffith, Sara; Pozniak, Myron A.; Mitchell, Carol; Ledwidge, Michael E.; Dempsey, Robert F.; Peters, Amy T.; Taylor, Erin

doi:10.7863/jum.2004.23.8.1065

Cited by 13 publications

(11 citation statements)

References 12 publications

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“…Many authors have described the intraoperative use of ultrasound with and without Doppler to help guide resection in the adult population, 2,4,6,8,10,12,20,[22][23][24]26,27,28 while others have shown the benefits of integrated neuronavigation. 1,14,22 Intraoperative angiography and indocyanine green video-angiography have also been used in conjunction with intraoperative Doppler ultrasound to aid AVM resection in the adult population.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have described ultrasound with and without intravenous contrast in AVM surgery in adults to aid resection, to check the extent of resection, and to increase overall surgical confidence. 4,6,8,10,24,26,28 Other authors have reported using neuronavigational software in conjunction with intraoperative ultrasound. 1,14,22 Intraoperative angiography or intraoperative indocyanine green video-angiography (ICGA) has also been used in conjunction with intraoperative Doppler ultrasound to aid AVM resection.…”

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confidence: 99%

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Use of intraoperative Doppler ultrasound with neuronavigation to guide arteriovenous malformation resection: a pediatric case series

Walkden¹,

Zádor²,

Herwadkar³

et al. 2015

PED

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OBJECT Over the last 20 years, several intraoperative adjuncts, including ultrasonography, neuronavigation, and angiography, have been said to aid the intraoperative localization and resection of cerebral arteriovenous malformations (AVMs). The authors assessed the value of intraoperative Doppler ultrasonography in conjunction with neuronavigation during surgery for cerebral AVMs in the pediatric population. METHODS The authors reviewed all cranial AVM resections performed by a single surgeon at their institution in the period from 2007 to 2013 and here describe their experience and results in a series of 20 consecutive AVM resections in 19 pediatric patients. Intraoperative Doppler ultrasonography had been used in conjunction with preoperative CT or neuronavigational MRI. Preoperative and postoperative clinical findings, patient age, and Spetzler-Martin AVM grade were identified in all patients. RESULTS All patients, whose ages ranged from 2 to 16 years, underwent craniotomy and excision of an AVM, which was supratentorial in 18 cases and infratentorial in 2. Patients in 11 cases underwent preoperative embolization, and all other patients underwent cerebral angiography prior to surgery, except for 2 patients who were urgently surgically treated because of low Glasgow Coma Scale scores and associated hematoma. Spetzler-Martin Grades I (3 cases), II (6), III (7), and IV (4) AVMs were represented in this series. Intraoperative Doppler ultrasound provided high-quality images in all cases and demonstrated the location, size, and flow characteristics of the AVM and any associated hematoma. Delayed postoperative cerebral angiography demonstrated successful AVM resection in all cases. An assessment of clinical outcomes revealed no new long-term neurological deficits at 3 months postoperatively. CONCLUSIONS Intraoperative Doppler ultrasonography is a reliable and useful tool for intraoperative localization and guidance for AVM resection in the pediatric population. When used in conjunction with neuronavigation equipment and modern microscopes, this technique has shown a very high complete resection rate with extremely low associated morbidity.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Use of intraoperative Doppler ultrasound with neuronavigation to guide arteriovenous malformation resection: a pediatric case series

Walkden¹,

Zádor²,

Herwadkar³

et al. 2015

PED

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“…As a noninvasive method, however, TCCS is very suitable for postoperative follow-up examinations and for postembolization monitoring, particularly if the AVM is located in the temporal or deep basal brain regions, as well as for intraoperative sonography. 27 The method can be regarded as a useful supplement to the palette of established noninvasive diagnostic techniques such as MRI and magnetic resonance angiography.…”

Section: A B Cmentioning

confidence: 99%

Evaluation of Arteriovenous Malformations (AVMs) With Transcranial Color-Coded Duplex Sonography

Bartels

2005

Journal of Ultrasound in Medicine

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“…It is a valuable adjunct in the localization and excision of the AVM and has been used in AVM surgery. The value of intraoperative real-time ultrasound during surgery of AVMs has been investigated by many researchers [11,[30][31][32][33][34][35][36] . The niduses of AVM are localized and defined precisely by ultrasound due to their dichromatic flow pattern.…”

Section: Intraoperationmentioning

confidence: 99%

The application of ultrasound in the management of cerebral arteriovenous malformation

Fan

Zhao

2008

Neurosci. Bull.

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Ultrasound is used in the diagnosis, treatment and follow-up of cerebral arteriovenous malformation (AVM). Several parameters including flow velocity, flow volume, resistance index, pulsatility index, vasomotor reactivity and their influencing factors are reviewed. The applications of ultrasound in the preoperative evaluation, intraoperative monitor and postoperative follow-up of AVM, are summarized. Although some limits exist, ultrasound can provide more reliable information about AVM, if lesions are classified according to their characteristics, compared in different conditions between preoperation and postoperation, feeding and non-feeding side, patients and healthy adults, and if ultrasound method is combined with other examinations and different developed ultrasound techniques. With the appearance and development of new ultrasound technique, its application will be wider in management of AVM.

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Intraoperative Sonography of Intracranial Arteriovenous Malformations

Abstract: Our experience has indicated that a combination of sonographic imaging and color and spectral Doppler imaging improves surgical resection of such lesions.

Cited by 13 publications

References 12 publications

Use of intraoperative Doppler ultrasound with neuronavigation to guide arteriovenous malformation resection: a pediatric case series

Use of intraoperative Doppler ultrasound with neuronavigation to guide arteriovenous malformation resection: a pediatric case series

Evaluation of Arteriovenous Malformations (AVMs) With Transcranial Color-Coded Duplex Sonography

The application of ultrasound in the management of cerebral arteriovenous malformation

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