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Brain arteriovenous malformation

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https://www.readbyqxmd.com/read/28072804/multidisciplinary-care-of-unruptured-brain-arteriovenous-malformations-to-improve-symptomatic-headache-and-the-onset-progression-and-outcomes-of-unruptured-brain-arteriovenous-malformations
#1
Ling-Feng Lai, Min Chen, Jia-Xiang Chen, Kuang Zheng, Xu-Ying He, Xi-Feng Li, Xin Zhang, Jian Yin, Qiu-Jing Wang, Tuan-Ming Zou, Chuan-Zhi Duan
BACKGROUND: Symptomatic headaches attributed to unruptured brain arteriovenous malformations (ubAVMs) are very common and affect patients' quality life, but multidisciplinary care of ubAVMs to improve symptomatic headache remains unclear. OBJECTIVE: The objective is to identify the features of symptomatic headaches, and to obtain headache outcomes following multidisciplinary care of ubAVMs, as well as provide background on the natural history of ubAVMs. STUDY DESIGN: The features of symptomatic headaches and headache outcomes were analyzed in a large cohort of cases after multidisciplinary care of ubAVMs...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28054837/radiosurgery-alters-the-endothelial-surface-proteome-externalized-intracellular-molecules-as-potential-vascular-targets-in-irradiated-brain-arteriovenous-malformations
#2
Lucinda S McRobb, Vivienne S Lee, Margaret Simonian, Zhenjun Zhao, Santhosh George Thomas, Markus Wiedmann, Jude V Amal Raj, Michael Grace, Vaughan Moutrie, Matthew J McKay, Mark P Molloy, Marcus A Stoodley
Stereotactic radiosurgery (SRS) is an established treatment for brain arteriovenous malformations (AVMs) that drives blood vessel closure through cellular proliferation, thrombosis and fibrosis, but is limited by a delay to occlusion of 2-3 years and a maximum treatable size of 3 cm. In this current study we used SRS as a priming tool to elicit novel protein expression on the endothelium of irradiated AVM vessels, and these proteins were then targeted with prothrombotic conjugates to induce rapid thrombosis and vessel closure...
January 5, 2017: Radiation Research
https://www.readbyqxmd.com/read/28050436/symptomatic-granuloma-secondary-to-embolic-agent-a-case-report
#3
Prashant Gunawat, Salman Tehran Shaikh, Vikram Karmarkar, Chandrashekhar Deopujari
Onyx is a liquid embolic agent presently gaining wide acceptance for embolisation of multiple vascular cranial pathologies like Arteriovenous Malformation (AVM) and Arteriovenous Fistula (AVF). Onyx stays in the nidus of vascular pathology and initiates inflammatory response leading to thrombosis and subsequently resulting in occlusion of vascular nidus. However, if onyx spills into the surrounding brain tissue, reaction occurs in the form of foreign body inflammatory reaction. This is one of the very few cases in literature whereby embolisation of AVM with onyx lead to granuloma formation which needed surgical excision...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28042014/microsurgical-outcome-of-unruptured-brain-arteriovenous-malformations-a-single-center-experience
#4
Xianzeng Tong, Jun Wu, Yong Cao, Yuanli Zhao, Shuo Wang, Jizong Zhao
OBJECTIVE: We aimed to describe our single-center experience in treating unruptured brain arteriovenous malformations (uBAVMs) with microsurgical treatment. METHODS: During a 7-year period, 282 patients with uBAVMs were surgically treated at our institution. Patient clinical features, post-surgical complications, AVM obliteration rate, seizure control and functional outcome were collected and analyzed. Seizure control was evaluated with the Engel Seizure Outcome Scale...
December 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28031662/hereditary-hemorrhagic-telangiectasia-and-myocardial-infarction
#5
Efrén Martínez-Quintana, Fayna Rodríguez-González, Silvia Gopar-Gopar
Hereditary hemorrhagic telangiectasia, also known as Osler-Weber-Rendu syndrome, is an autosomal dominant genetic disorder that leads to epistaxis, gastrointestinal bleeding, iron deficiency anemia, and arteriovenous malformations at the lungs, the liver, and the brain. However, due to its rarity and its unspecific findings on routine examinations, diagnosis is not easy unless suspected due to hypoxemia or paradoxical embolism. We present a case of a 46-year-old-woman with hereditary hemorrhagic telangiectasia and hypoxemia who presented a myocardial infarction secondary to paradoxical embolism through pulmonary arteriovenous malformations...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28017742/embolization-followed-by-radiosurgery-for-the-treatment-of-brain-arteriovenous-malformations-avms
#6
Michael P Marks, Mary L Marcellus, Justin Santarelli, Robert L Dodd, Huy M Do, Steven D Chang, John R Adler, Michael Mlynash, Gary K Steinberg
BACKGROUND: Embolization has been proposed to reduce the size of the AVM nidus in advance of radiosurgical treatment. However, embolization followed by radiosurgery for brain AVMs is controversial. OBJECTIVE: This study assessed the impact of embolization on nidal size prior to radiosurgical treatment and evaluated cure rates and complications using embolization followed by radiosurgery. METHODS: Retrospective review of our institutional AVM database identified 91 patients treated from 1995-2009 with embolization followed by radiosurgery...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28011359/detection-of-a-rare-complication-of-endovascular-treatment-for-brain-avm-by-echocardiography
#7
Mozhgan Parsaee, Sedigheh Saedi, Sepideh Emami, Alireza Serati
A brain arteriovenous malformation (AVM) is a congenital malformation of the vascular system, in which an abnormal short circuit (vascular malformation) connects cerebral arteries and veins. When the brain AVMs are diagnosed, the majority of them must be closed with surgical or endovascular treatment; because only a small portion of the brain AVMs remain asymptomatic during the patient's life. Endovascular trans-arterial embolization using Onyx is a suitable method of treating brain AVMs. Previously known complications of onyx usage are bleeding and neurologic deficits...
December 21, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28009228/microsurgery-for-spetzler-ponce-class-a-and-b-arteriovenous-malformations-utilizing-an-outcome-score-adopted-from-gamma-knife-radiosurgery-a-prospective-cohort-study
#8
Michael K Morgan, Markus K Hermann Wiedmann, Marcus A Stoodley, Gillian Z Heller
OBJECTIVE The purpose of this study was to adapt and apply the extended definition of favorable outcome established for Gamma Knife radiosurgery (GKRS) to surgery for brain arteriovenous malformations (bAVMs). The aim was to derive both an error around the point estimate and a model incorporating angioarchitectural features in order to facilitate comparison among different treatments. METHODS A prospective microsurgical cohort was analyzed. This cohort included patients undergoing embolization who did not proceed to microsurgery and patients denied surgery because of perceived risk of treatment...
December 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28009020/the-relationship-of-cortical-folding-and-brain-arteriovenous-malformations
#9
Manish N Shah, Sarah E Smith, Donna L Dierker, Joseph P Herbert, Timothy S Coalson, Brent S Bruck, Gregory J Zipfel, David C Van Essen, Ralph G Dacey
BACKGROUND: The pathogenesis of human intracranial arteriovenous malformations (AVMs) is not well understood; this study aims to quantitatively assess cortical folding in patients with these lesions. METHODS: Seven adult participants, 4 male and 3 female, with unruptured, surgically unresectable intracranial AVMs were prospectively enrolled in the study, with a mean age of 42.1 years and Spetzler-Martin grade range of II-IV. High-resolution brain MRI T1 and T2 sequences were obtained...
2016: Neurovasc Imaging
https://www.readbyqxmd.com/read/27982772/deliberate-employment-of-postoperative-hypotension-for-brain-arteriovenous-malformation-surgery-and-the-incidence-of-delayed-postoperative-hemorrhage-a-prospective-cohort-study
#10
Michael Kerin Morgan, Markus Karl Hermann Wiedmann, Nazih N A Assaad, Michael J A Parr, Gillian Z Heller
OBJECTIVE The aim of this study was to examine the impact of deliberate employment of postoperative hypotension on delayed postoperative hemorrhage (DPH) for all Spetzler-Ponce Class (SPC) C brain arteriovenous malformations (bAVMs) and SPC B bAVMs ≥ 3.5 cm in diameter (SPC B 3.5+). METHODS A protocol of deliberate employment of postoperative hypotension was introduced in June 1997 for all SPC C and SPC B 3.5+ bAVMs. The aim was to achieve a maximum mean arterial blood pressure (BP) ≤ 70 mm Hg (with cerebral perfusion pressure > 50 mm Hg) for a minimum of 7 days after resection of bAVMs (BP protocol)...
December 16, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27981065/art-3-5d-an-algorithm-to-label-arteries-and-veins-from-three-dimensional-angiography
#11
Beatrice Barra, Elena De Momi, Giancarlo Ferrigno, Guglielmo Pero, Francesco Cardinale, Giuseppe Baselli
Preoperative three-dimensional (3-D) visualization of brain vasculature by digital subtraction angiography from computerized tomography (CT) in neurosurgery is gaining more and more importance, since vessels are the primary landmarks both for organs at risk and for navigation. Surgical embolization of cerebral aneurysms and arteriovenous malformations, epilepsy surgery, and stereoelectroencephalography are a few examples. Contrast-enhanced cone-beam computed tomography (CE-CBCT) represents a powerful facility, since it is capable of acquiring images in the operation room, shortly before surgery...
October 2016: Journal of Medical Imaging
https://www.readbyqxmd.com/read/27913800/the-transvenous-pressure-cooker-technique-a-treatment-for-brain-arteriovenous-malformations
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
January 2017: 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
#19
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
#20
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
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