The Application of Serial Angiography to Diagnosis of the Smallest Cerebral Angiomatous Malformations

Jensen, H.-P.; Brumlik, Joel; Boshes, Benjamin

doi:10.1097/00005053-196301000-00001

Cited by 21 publications

(4 citation statements)

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“…These lesions typically consist of a plexiform AVM nidus or multiple tiny arterioles draining into an arterialized vein (fistulous type). Deruty and associates, 3 Jensen et al, 5 Willinsky et al, 17,18 Stiver and Ogilvy, 12 Cellerini et al, 2 and Perrini et al 8 have described small series of patients with micro-AVMs who presented mainly with intracranial hematoma. Willinsky and associates 17 have speculated that micro-AVMs have large bridging arteries that anchor the draining veins to the brain parenchyma producing outflow obstruction and increased venous pressure.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of intracranial microarteriovenous malformations

Andreou

Ioannidis

Lalloo

et al. 2008

JNS

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Section: Discussionmentioning

confidence: 99%

Endovascular treatment of intracranial microarteriovenous malformations

Andreou

Ioannidis

Lalloo

et al. 2008

JNS

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“…7 Others have advocated for exploration of the hematoma wall at the time of emergent evacuation to identify an arterialized draining vein that can lead to an occult micro-AVM. 3 10 11…”

Section: Discussionmentioning

confidence: 99%

“…7 Others have advocated for exploration of the hematoma wall at the time of emergent evacuation to identify an arterialized draining vein that can lead to an occult micro-AVM. 3,10,11 Treatment strategies for micro-AVMs include microsurgical resection, endovascular embolization, and/or radiosurgery. For superficial cortical lesions in noneloquent cortex, microsurgical resection is advocated.…”

Section: Discussionmentioning

confidence: 99%

Gross Total Resection of a Ruptured Micro-arteriovenous Malformation within the Cerebellar Peduncle: A Case Report and Qualitative Review of the Literature

Iqbal

Lariccia

Markosian

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

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Deep-seated micro-arteriovenous malformations (micro-AVMs) may pose a challenge for complete yet safe resection. We propose the strategic placement of two to three microaneurysm clips throughout the hemorrhage cavity to successfully localize the micro-AVM nidus via digital subtraction angiography (DSA). We successfully demonstrate this novel method in a 15-year-old adolescent boy with cerebellar intraparenchymal hemorrhage who underwent hematoma evacuation and expansile duraplasty. He was found to have a 1-cm nidus of a micro-AVM with early venous drainage located in the right middle cerebellar peduncle. Five days later, we proceeded to resect the micro-AVM; however, a clear nidus or bleeding source was unable to be localized intraoperatively despite the use of stereotactic neuronavigation. In turn, we placed two mini-aneurysm clips superiorly and inferiorly within the hematoma cavity, which led to successful localization via DSA and complete resection. No surgical complications occurred. The patient completely recovered from right-sided weakness and dysarthria 6 to 12 months postoperatively. Our technique allows for the rapid localization and complete resection of micro-AVM nidi when stereotactic neuronavigation is inadequate.

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“…As limited case series of micro-AVMs have ever been reported, 3 , 6 , 12 , 13) there are still a lot of unknown characteristics of micro-AVMs. Most of micro-AVMs were reported to occur in between children and young people under 50 years of age.…”

Section: Discussionmentioning

confidence: 99%

Role of Endovascular Approach as Diagnostic Technique and First-Line Therapy for the Patients with Micro-Arteriovenous Malformations: A Case Report and Literature Review

Saito

Miyata

Miyauchi

et al. 2022

JNET

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Objective: We describe a rare case report of micro-arteriovenous malformation (micro-AVM) treated by the endovascular approach in addition with literature review.Case Presentation: A 12-year-old boy presenting with a spontaneous intracerebral hematoma in the left occipital lobe underwent conventional diagnostic workups. The results of initial catheter angiography were considered to be equivocal as the AVM. Superselective angiography (SA) demonstrated a micro or small AVM (single feeder and single drainer type) with an aneurysmal dilatation. Immediate transarterial embolization (TAE) might fail to occlude the whole of nidus area completely, and subsequently, we switched to the surgical exploration of AVM lesion. Intraoperative findings demonstrated that the whole of AVM lesion had already been occluded completely, indicating the complete occlusion by TAE only. Pathological findings of the surgical specimen showed an aneurysmal dilatation was a venous aneurysm with vulnerable vascular wall structure, which was certainly the source of bleeding. Based on the above results, the retrospective revaluation of superselective angiogram permitted us to understand that the nidus of AVM was micro nidus type and TAE had resulted in the complete nidus occlusion. Conclusion:SA is the most useful diagnostic modality to clarify the angioarchitecture of micro-AVM and AVM-related aneurysms. If SA is successfully performed and relatively safe TAE is expected to be possible, the subsequent attempt to do curative embolization as a first-line treatment may be worthy of consideration. However, the surgical procedure should be fully reserved for the possible incomplete obliteration and hemorrhagic complications.

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The Application of Serial Angiography to Diagnosis of the Smallest Cerebral Angiomatous Malformations

Cited by 21 publications

References 0 publications

Endovascular treatment of intracranial microarteriovenous malformations

Endovascular treatment of intracranial microarteriovenous malformations

Gross Total Resection of a Ruptured Micro-arteriovenous Malformation within the Cerebellar Peduncle: A Case Report and Qualitative Review of the Literature

Role of Endovascular Approach as Diagnostic Technique and First-Line Therapy for the Patients with Micro-Arteriovenous Malformations: A Case Report and Literature Review

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