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Brain arteriovenous malformation

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https://www.readbyqxmd.com/read/27913800/the-transvenous-pressure-cooker-technique-a-treatment-for-brain-arteriovenous-malformations
#1
Guang Zhang, Shiyi Zhu, Pei Wu, Shancai Xu, Huaizhang Shi
The treatment of brain arteriovenous malformations (AVMs) remains a significant challenge, especially hemorrhagic AVMs which are unsuitable for microsurgery or radiosurgery. We demonstrate an AVM located in the left basal ganglia area, supplied by slender arteries, and treated by the transvenous pressure cooker technique. Herein, we describe the procedure and outline the crucial points and indications for this technique.
December 2, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27911249/international-multicenter-cohort-study-of-pediatric-brain-arteriovenous-malformations-part-2-outcomes-after-stereotactic-radiosurgery
#2
Robert M Starke, Dale Ding, Hideyuki Kano, David Mathieu, Paul P Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
OBJECTIVE Pediatric patients (age < 18 years) harboring brain arteriovenous malformations (AVMs) are burdened with a considerably higher cumulative lifetime risk of hemorrhage than adults. Additionally, the pediatric population was excluded from recent prospective comparisons of intervention versus conservative management for unruptured AVMs. The aims of this multicenter, retrospective cohort study are to analyze the outcomes after stereotactic radiosurgery for unruptured and ruptured pediatric AVMs. METHODS We analyzed and pooled AVM radiosurgery data from 7 participating in the International Gamma Knife Research Foundation...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27911248/international-multicenter-cohort-study-of-pediatric-brain-arteriovenous-malformations-part-1-predictors-of-hemorrhagic-presentation
#3
Dale Ding, Robert M Starke, Hideyuki Kano, David Mathieu, Paul P Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
OBJECTIVE Brain arteriovenous malformations (AVMs) are the most common cause of spontaneous intracranial hemorrhage in pediatric patients (age < 18 years). Since the cumulative lifetime risk of AVM hemorrhage is considerable in children, an improved understanding of the risk factors influencing hemorrhagic presentation may aid in the management of pediatric AVMs. The aims of this first of a 2-part multicenter, retrospective cohort study are to evaluate the incidence and determine the predictors of hemorrhagic presentation in pediatric AVM patients...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27911246/role-of-follow-up-imaging-after-resection-of-brain-arteriovenous-malformations-in-pediatric-patients-a-systematic-review-of-the-literature
#4
Joaquin E Jimenez, Zachary C Gersey, Jason Wagner, Brian Snelling, Sudheer Ambekar, Eric C Peterson
OBJECTIVE Pediatric patients are at risk for the recurrence of brain arteriovenous malformation (AVM) after resection. While there is general consensus on the importance of follow-up after surgical removal of an AVM, there is a lack of consistency in the duration of that follow-up. The object of this systematic review was to examine the role of follow-up imaging in detecting AVM recurrence early and preventing AVM rupture. METHODS This systematic review was performed using articles obtained through a search of the literature contained in the MeSH database, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27903925/onyx-extravasation-during-embolization-of-a-brain-arteriovenous-malformation
#5
Hiroyuki Ikeda, Hirotoshi Imamura, Yuji Agawa, Yukihiro Imai, Shoichi Tani, Hidemitsu Adachi, Tatsuya Ishikawa, Yohei Mineharu, Nobuyuki Sakai
During Onyx embolization to treat brain arteriovenous malformation (AVM), carefully observing the penetration of Onyx to the nidus is important in order to avoid complications such as hemorrhage, ischemia, and difficulty with microcatheter removal. We encountered a case of Onyx extravasation during embolization of a cerebellar AVM confirmed by surgical resection and pathological analysis. The patient was a 44-year-old man with Spetzler-Martin grade I cerebellar AVM who underwent Onyx embolization prior to resection of the brain AVM...
November 30, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27900505/subsequent-haemorrhage-in-children-with-untreated-brain-arteriovenous-malformation-higher-risk-with-unbalanced-inflow-and-outflow-angioarchitecture
#6
Li Ma, Xiao-Lin Chen, Yu Chen, Chun-Xue Wu, Jun Ma, Yuan-Li Zhao
OBJECTIVES: Children with brain arteriovenous malformations (bAVMs) are at risk of life-threatening haemorrhage in their early lives. Our aim was to analyse various angioarchitectural features of bAVM to predict the risk of subsequent haemorrhage during follow-up in children. METHODS: We identified all consecutive children admitted to our institution for bAVMs between July 2009 and September 2015. Children with at least 1 month of treatment-free follow-up after diagnosis were included in further analysis...
November 29, 2016: European Radiology
https://www.readbyqxmd.com/read/27899758/estimating-the-risks-of-adverse-radiation-effects-after-gamma-knife-radiosurgery-for-arteriovenous-malformations
#7
Hideyuki Kano, John C Flickinger, Daniel Tonetti, Alan Hsu, Huai-Che Yang, Thomas J Flannery, Ajay Niranjan, L Dade Lunsford
BACKGROUND AND PURPOSE: We evaluated risk factors associated with the development of adverse radiation effects (ARE) after stereotactic radiosurgery (SRS) for cerebral arteriovenous malformations (AVMs). METHODS: We evaluated 755 patients with AVM who underwent a single Gamma Knife SRS procedure with at least a 2-year minimum follow-up. Eighty-seven patients (12%) underwent previous resection and 128 (17%) had previous embolization. The median target volume was 3...
November 29, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27894886/utility-of-urgent-computed-tomography-angiography-in-the-setting-of-intraparenchymal-brain-hemorrhage
#8
Omran Kaskar, Larry B Goldstein
BACKGROUND AND PURPOSE: Patients presenting with an intracerebral hemorrhage (ICH) generally have an initial noncontrast computed tomography (NCCT) of the brain. Computed tomography angiography (CTA) can help identify secondary causes of ICH and detect a "spot sign." We hypothesized that performing an urgent CTA in the setting of a presumed primary ICH has only limited utility and did not alter urgent management. METHODS: This was a retrospective study of consecutive patients presenting with a primary ICH identified from the Duke University Stroke Registry from 2010 to 2013 who had an ICH detected on an initial NCCT...
November 25, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27869147/interplay-between-vegf-and-nrf2-regulates-angiogenesis-due-to-intracranial-venous-hypertension
#9
Liwen Li, Hao Pan, Handong Wang, Xiang Li, Xiaomin Bu, Qiang Wang, Yongyue Gao, Guodao Wen, Yali Zhou, Zixiang Cong, Youqing Yang, Chao Tang, Zhengwei Liu
Venous hypertension(VH) plays an important role in the pathogenesis of cerebral arteriovenous malformations (AVMs) and is closely associated with the HIF-1α/VEGF signaling pathway. Nuclear factor erythroid 2-related factor 2(Nrf2) significantly influences angiogenesis; however, the interplay between Nrf2 and VEGF under VH in brain AVMs remains unclear. Therefore, our study aimed to investigate the interplay between Nrf2 and VEGF due to VH in brain AVMs. Immunohistochemistry indicated that Nrf2 and VEGF were highly expressed in human brain AVM tissues...
November 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27856955/microsurgery-for-aruba-trial-a-randomized-trial-of-unruptured-brain-arteriovenous-malformation-eligible-unruptured-brain-arteriovenous-malformations
#10
Johnny Wong, Alana Slomovic, George Ibrahim, Ivan Radovanovic, Michael Tymianski
BACKGROUND AND PURPOSE: The management of unruptured brain arteriovenous malformations (ubAVMs) remains controversial despite ARUBA trial (A Randomized Trial of Unruptured Brain Arteriovenous Malformation), a controlled trial that suggested superiority of conservative management over intervention. However, microsurgery occurred in only 14.9% of ARUBA intervention cases, raising concerns about the study's generalizability. Our purpose was to evaluate whether, in a larger ARUBA-eligible ubAVM population, microsurgery produces acceptable outcomes...
November 17, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27835916/neuropsychological-performance-after-brain-arteriovenous-malformations-treatment
#11
Ondrej Bradac, Alice Pulkrabkova, Patricia de Lacy, Vladimir Benes
Background The treatment of brain arteriovenous malformations (AVMs) has been studied extensively. With the use of the Spetzler-Martin (S-M) grading system, patients can be informed appropriately about their possible surgical risks. This does not hold true for their neuropsychological sequelae, which have not been studied widely. We evaluated the neuropsychological outcome of our patients treated for brain AVMs. Methods Of 113 patients treated for a brain AVM between 2001 and 2009, 66 patients were enrolled in the study...
November 11, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27816341/stroke-prevention
#12
Clothilde Isabel, David Calvet, Jean-Louis Mas
Patients who have had a stroke are at high risk for recurrent stroke, myocardial infarction, and vascular death. Prevention of these events should be initiated promptly after stroke, because many recurrent events occur early, and should be tailored to the precise cause of stroke, which may require specific treatment. Lifestyle advice including abstinence from smoking, regular exercise, Mediterranean-style diet, and reduction of salt intake and alcohol consumption are recommended for all patients with stroke...
November 3, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27810415/interventional-therapy-for-brain-arteriovenous-malformations-before-and-after-aruba
#13
Eric S Sussman, Aditya K Iyer, Mario Teo, Arjun V Pendharkar, Allen L Ho, Gary K Steinberg
The ARUBA trial (2014) concluded that medical management alone is superior to medical management plus interventional therapy for the treatment of unruptured brain arteriovenous malformations (bAVMs). This sparked considerable controversy among involved healthcare providers. Here, we evaluated the impact of ARUBA on the volume, type, and treatment modality of bAVMs referred to a large tertiary care center. This was achieved by conducting a retrospective review of a prospectively maintained database of all bAVMs treated at Stanford Health Care and Stanford Children's Health from January 2012 through July 2015...
October 31, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27789452/intracranial-arteriovenous-shunting-detection-with-arterial-spin-labeling-and-susceptibility-weighted-imaging-combined
#14
J Hodel, X Leclerc, E Kalsoum, M Zuber, R Tamazyan, M A Benadjaoud, J-P Pruvo, M Piotin, H Baharvahdat, M Zins, R Blanc
BACKGROUND AND PURPOSE: Arterial spin-labeling and susceptibility-weighted imaging are 2 MR imaging techniques that do not require gadolinium. The study aimed to assess the accuracy of arterial spin-labeling and SWI combined for detecting intracranial arteriovenous shunting in comparison with conventional MR imaging. MATERIALS AND METHODS: Ninety-two consecutive patients with a known (n = 24) or suspected arteriovenous shunting (n = 68) underwent digital subtraction angiography and brain MR imaging, including arterial spin-labeling/SWI and conventional angiographic MR imaging (3D TOF, 4D time-resolved, and 3D contrast-enhanced MRA)...
October 27, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/27787648/cerebrofacial-arteriovenous-metameric-syndrome-cams-a-spectrum-disorder-of-craniofacial-vascular-malformations
#15
Lauren O'Loughlin, Mari L Groves, Neil R Miller, Monica S Pearl
Cerebrofacial arteriovenous metameric syndrome (CAMS) is a recent classification of vascular malformations that encompasses a spectrum of phenotypic expression involving arteriovenous malformations (AVMs) of the cerebral, orbital, and facial region. Recognizing the embryologic basis of CAMS is important for diagnosing other AVMs along the same metameric level. Visual loss is the most common presentation prompting ophthalmologic evaluation followed by neuroimaging. We present two pediatric patients with ipsilateral optic nerve and chiasmal AVMs without cutaneous manifestations, characteristic of CAMS 2...
October 27, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27769582/-orbito-palpebral-vascular-pathology
#16
F Heran Dreyfus, O Galatoire, P Koskas, F Lafitte, E Nau, O Bergès
Orbito-palpebral vascular pathology represents 10% of all the diseases of this area. The lesion may be discovered during a brain CT scan or MRI, or because it causes clinical symptoms such as orbital mass, visual or oculomotor alteration, pain, proptosis, or acute bleeding due to a complication of the lesion (hemorrhage, thrombosis). We present these lesions using an anatomical, clinical, imaging and therapeutic approach. We distinguish four different entities. Vascular tumors have common imaging characteristics (hypersignal on T2 sequence, contrast enhancement, abnormal vascularization well depicted with ultrasound and Doppler, and possible bleeding)...
October 18, 2016: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/27767404/prevalence-and-characteristics-of-brain-arteriovenous-malformations-in-hereditary-hemorrhagic-telangiectasia-a-systematic-review-and-meta-analysis
#17
Waleed Brinjikji, Vivek N Iyer, Christopher P Wood, Giuseppe Lanzino
OBJECTIVE Patients with hereditary hemorrhagic telangiectasia (HHT) are known to suffer from high rates of cerebral arteriovenous malformations (AVMs). The authors performed a systematic review and meta-analysis of the literature examining prevalence rates, characteristics, and clinical presentation of cerebral AVMs in the HHT population. METHODS To identify studies on AVM prevalence and characteristics in the HHT population, 4 databases (MEDLINE, EMBASE, Scopus and Web of Science) were searched by a reference librarian with over 30 years experience in systematic reviews and meta-analysis...
October 21, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27760058/time-of-arrival-parametric-maps-and-virtual-bolus-images-derived-from-contrast-enhanced-time-resolved-radial-magnetic-resonance-angiography-improve-the-display-of-brain-arteriovenous-malformation-vascular-anatomy
#18
Tilman Schubert, Yijing Wu, Kevin M Johnson, Oliver Wieben, Jane Maksimovic, Charles Mistretta, Patrick Turski
OBJECTIVES: Time-of-arrival (TOA) maps can be derived from high-resolution 4-dimensional (4D) contrast-enhanced magnetic resonance angiography (MRA) data sets to provide a quantitative description of contrast material arrival time in each voxel. This information can further be processed to create a compressed time evolution curve that virtually shortens the contrast bolus (virtual bolus [VB]). The purpose of this project was to determine whether TOA-enhanced 4D MRA and/or VB imaging improve the display of contrast kinetics in patients with vascular disease...
November 2016: Investigative Radiology
https://www.readbyqxmd.com/read/27755938/arterial-spin-labeling-perfusion-of-the-brain-emerging-clinical-applications
#19
Sven Haller, Greg Zaharchuk, David L Thomas, Karl-Olof Lovblad, Frederik Barkhof, Xavier Golay
Arterial spin labeling (ASL) is a magnetic resonance (MR) imaging technique used to assess cerebral blood flow noninvasively by magnetically labeling inflowing blood. In this article, the main labeling techniques, notably pulsed and pseudocontinuous ASL, as well as emerging clinical applications will be reviewed. In dementia, the pattern of hypoperfusion on ASL images closely matches the established patterns of hypometabolism on fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) images due to the close coupling of perfusion and metabolism in the brain...
November 2016: Radiology
https://www.readbyqxmd.com/read/27713067/clinical-experience-with-intraoperative-ultrasound-image-in-microsurgical-resection-of-cerebral-arteriovenous-malformations
#20
Hongzhi Xu, Zhiyong Qin, Ming Xu, Chunjui Chen, Junjie Zhang, Xiancheng Chen
BACKGROUND: Intraoperative ultrasound is widely used in neurosurgery for the management of intracerebral hematoma and brain tumor. However, the clinical value of this method in the surgery of cerebral arteriovenous malformations (AVMs) has not been reported. In this study, the application of intraoperative ultrasound for AVMs surgery was evaluated prospectively. METHODS: This prospective clinical study comprised of 41 patients who underwent microsurgical resection of cerebral AVMs at our institute...
October 3, 2016: World Neurosurgery
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