Surgical approaches to treatment of arteriovenous malformations

Aziz-Sultan, Mohammed Ali; Elhammady, Mohamed Samy; Heros, Roberto C.

doi:10.1017/cbo9781139523943.013

Cited by 3 publications

(1 citation statement)

References 232 publications

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“…There were no further episodes of right-sided weakness, which may have been due to a steal phenomenon caused by high-flow pAVFs leading to a decrease in arterial supply along with underlying cortical pathology [4] .…”

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confidence: 87%

Pial Arteriovenous Fistula and Capillary Malformation-Arteriovenous Malformation Associated with RASA1 Mutation: 2 Pediatric Cases with Successful Surgical Management

Chugh

Shahid²,

Manjila³

et al. 2017

Pediatr Neurosurg

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We present case reports of 2 pediatric patients who were both found to have pial arteriovenous fistulas (AVFs) with subsequent genetic analysis revealing mutations in the RASA1 gene. Considering their family history of distinct cutaneous lesions, these mutations were likely inherited as opposed to de novo mutations. Patient 1 had large capillary malformations on the left side of the face and neck, associated with macrocephaly, and presented at the age of 32 months with speech delay, right-sided weakness, and focal seizures involving the right side of the body. Patient 2 presented with proptosis at the age of 9 months, but was otherwise neurologically intact. Given the chance for definitive single-stage control of vascular shunt (obviating chances for radiation exposure with endovascular treatment) and surgically accessible location of these intracranial lesions, both patients were treated with surgery with excellent clinical and radiological outcome. In general, given the high mortality secondary to severe congestive heart failure when treated conservatively, the goal of treatment in cortical AVF in young children, even when asymptomatic, is rapid control of the shunt. This was achieved successfully in our cases - both patients experienced significant symptomatic improvement following surgery and remained neurologically stable in the subsequent follow-up visits.

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confidence: 87%

Pial Arteriovenous Fistula and Capillary Malformation-Arteriovenous Malformation Associated with RASA1 Mutation: 2 Pediatric Cases with Successful Surgical Management

Chugh

Shahid²,

Manjila³

et al. 2017

Pediatr Neurosurg

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Microsurgical Management of Posterior Fossa Vascular Lesions

Kalani

Spetzler

2017

Skull Base Surgery of the Posterior Fossa

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External validation of brain arteriovenous malformation haemorrhage scores, AVICH, ICH and R2eD

et al. 2022

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Purpose To externally validate the arteriovenous malformation-related intracerebral haemorrhage (AVICH), intracerebral haemorrhage (ICH), and novel haemorrhage presentation risk score (R2eD) in brain arteriovenous malformations. Methods Adult patients diagnosed radiologically with an arteriovenous malformation (AVM) at a tertiary neurosurgical centre between 2007 and 2018 were eligible for inclusion. Both the AVICH and ICH scores were calculated for AVM-related symptomatic haemorrhage (SH) and compared against the modified Rankin scale (mRS) at discharge and last follow-up, with unfavourable outcome defined as mRS > 2. R2eD scores were stratified based on presentation with SH. External validity was assessed using Harrel’s C-statistic. Results Two hundred fifty patients were included. Mean age at diagnosis was 46.2 years [SD = 16.5]). Eighty-seven patients (34.8%) had a SH, with 83 included in the analysis. Unfavourable mRS outcome was seen in 18 (21.6%) patients at discharge and 18 (21.6%) patients at last follow-up. The AVICH score C-statistic was 0.67 (95% confidence interval [CI], 0.53–0.80) at discharge and 0.70 (95% CI, 0.56–0.84) at last follow-up. The ICH score C-statistic was 0.78 (95% CI 0.67–0.88), at discharge and 0.80 (95% CI 0.69–0.91) at last follow-up. The R2eD score C-statistic for predicting AVM haemorrhage was 0.60 (95% CI, 0.53–0.67). Conclusions The AVICH score showed fair-poor performance, while the ICH score showed good-fair performance. The R2eD score demonstrated poor performance, and its clinical utility in predicting AVM haemorrhage remains unclear.

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Surgical approaches to treatment of arteriovenous malformations

Cited by 3 publications

References 232 publications

Pial Arteriovenous Fistula and Capillary Malformation-Arteriovenous Malformation Associated with <b><i>RASA1</i></b> Mutation: 2 Pediatric Cases with Successful Surgical Management

Pial Arteriovenous Fistula and Capillary Malformation-Arteriovenous Malformation Associated with <b><i>RASA1</i></b> Mutation: 2 Pediatric Cases with Successful Surgical Management

Microsurgical Management of Posterior Fossa Vascular Lesions

External validation of brain arteriovenous malformation haemorrhage scores, AVICH, ICH and R2eD

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