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Spetzler martin

David Yuen Chung Chan, Danny Tat Ming Chan, Cannon Xian Lun Zhu, Patricia Kwok Yee Kan, Amelia Yikjin Ng, Yi-Pin Sonia Hsieh, Jill Abrigo, Wai Sang Poon, George Kwok Chu Wong
Treatment of arteriovenous malformations (AVM) located at the eloquent area has been a challenge. Awake brain mapping allows identification of a non-eloquent gyrus for intervention and can potentially facilitate resection with preservation of functions. An alternative treatment option is stereotactic radiosurgery (SRS). The objective of this study was to perform a qualitative comparison of the treatment outcome of awake AVM excision versus SRS. We conducted a 13-year retrospective review of AVM excision under awake craniotomy performed at Prince of Wales Hospital, Hong Kong, from 2003 to 2016...
March 9, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Orhan Bican, Charles Cho, Leslie Lee, Viet Nguyen, Scheherazade Le, Jeremy Heit, Jaime Lopez
A middle-aged patient underwent staged endovascular embolization of a Spetzler-Martin grade V right parietal arteriovenous malformation(AVM).In the fifth endovascular embolization, after methohexital 10 mg injection into a right posterior choroidal artery feeding the AVM nidus, there was an immediate change in the electroencephalogram (EEG) with simultaneous loss of motor evoked potentials (MEPs) in the bilateral upper and lower extremities and a delayed change in somatosensory evoked potential responses (SSEPs)...
February 25, 2018: Clinical Imaging
Nicholas T Gamboa, Evan J Joyce, Ilyas Eli, Min S Park, Philipp Taussky, Richard H Schmidt, Jamie McDonald, Kevin J Whitehead, M Yashar S Kalani
Hereditary hemorrhagic telangiectasia (HHT) is characterized by recurrent spontaneous epistaxis, mucocutaneous telangiectases, and multisystem arteriovenous malformations (AVMs). Brain AVMs typically present at birth and are identified in approximately 10-20% of patients with HHT. A retrospective review was undertaken of all HHT patients with known single or multiple brain AVMs treated at our institution. Thirty-nine patients with brain AVM(s) were diagnosed with HHT. Most patients presented with at least one Curaçao criterion...
February 23, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Hari S Raman, Lakshmi Santanam, Ananth K Vellimana, Robert E Drzymala, Christina I Tsien, Gregory J Zipfel
BACKGROUND AND IMPORTANCE: Gamma Knife radiosurgery is an established technique for non-urgent treatment of various intracranial pathologies. Intra-procedural dislodgement of the stereotactic frame is an uncommon occurrence that could lead to abortion of ongoing treatment and necessitate more invasive treatment strategies. CLINICAL PRESENTATION: In this case report, we describe a novel method for resumption of Gamma Knife treatment after an unplanned intra-procedural interruption...
February 17, 2018: Acta Neurochirurgica
Mary Simons, Michael K Morgan, Andrew S Davidson
INTRODUCTION: There is uncertainty as to the best management of arteriovenous malformations of the brain (bAVM). However, the Spetzler-Martin grade (SMG) has been validated as an effective determinant of surgical risks. We performed a systematic review for the best evidence regarding the management of bAVM for series that incorporate an analysis based upon SMG. EVIDENCE ACQUISITION: Medline, Embase, Scopus and Cochrane databases were searched for series between January 2000 and January 2018, with a minimum of 100 cases and that incorporated SMG stratification...
February 13, 2018: Journal of Neurosurgical Sciences
C Q Li, A Hsiao, J Hattangadi-Gluth, J Handwerker, N Farid
Brain AVMs treated with stereotactic radiosurgery typically demonstrate a minimum latency period of 1-3 years between treatment and nidus obliteration. Assessment of treatment response is usually limited to evaluation of AVM nidus structural changes using conventional MR imaging and MRA techniques. This report describes the use of 4D Flow MRI to also measure radiation-induced hemodynamic changes in a Spetzler-Martin grade III AVM, which were detectable as early as 6 months after treatment.
January 25, 2018: AJNR. American Journal of Neuroradiology
Sebastian Ille, Thomas Picht, Ehab Shiban, Bernhard Meyer, Peter Vajkoczy, Sandro M Krieg
BACKGROUND: The treatment of brain arteriovenous malformations (BAVMs) is still contrarily discussed. Despite the debatable results of the ARUBA trial, most BAVMs still require treatment depending on the Spetzler-Martin (SM) grading. Since size is measurable and venous drainage is visible, the determination of eloquence is comparably crucial but not fully objective. The present bicentric cohort study aims to examine the influence of preoperative navigated transcranial magnetic stimulation (nTMS) motor and language mapping data on decision-making for or against surgical treatment of BAVMs...
March 2018: Acta Neurochirurgica
George A C Mendes, M Yashar S Kalani, Christina Iosif, Adson F Lucena, Rui Carvalho, Suzana Saleme, Charbel Mounayer
BACKGROUND: Curative transvenous embolization is an emerging strategy for treatment of cerebral arteriovenous malformations (AVMs). OBJECTIVE: To assess contemporary outcomes of transvenous embolization as a stand-alone therapy for cerebral AVMs. METHODS: We prospectively followed 40 patients with 41 AVMs who underwent transvenous endovascular therapy between January 2008 and January 2015. Patient demographics, AVM characteristics, endovascular techniques used, angiographic results, clinical outcomes, and complications were assessed independently...
December 21, 2017: Neurosurgery
Julien Ognard, Elsa Magro, Jildaz Caroff, Douraied Ben Salem, Sebastien Andouard, Michel Nonent, Jean-Christophe Gentric
BACKGROUND AND PURPOSE: The Spetzler and Martin (SM) cerebral arteriovenous malformation (AVM) classification is a widely used 5-tier classification. This common language allows specialists to exchange about AVMs and must be reliably characterized by the imaging methods. We presented an agreement study on a new method of digital subtracted 3D rotational angiography resolved in time (four-dimensional DSA: 4D DSA) compared to the gold standard (two-dimensional digital DSA: 2D DSA) in AVM grading using the SM classification...
December 20, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
Fei Cong, Yan Zhuo, Songlin Yu, Xianchang Zhang, Xinyuan Miao, Jing An, Shuo Wang, Yong Cao, Yan Zhang, Hee Kwon Song, Danny Jj Wang, Lirong Yan
BACKGROUND: Arterial spin labeling (ASL) based-noncontrast-enhanced 4D MR angiography (NCE 4D MRA) shows potential in characterizing cerebrovascular hemodynamics in cerebrovascular disorders. Ultrahigh-field theoretically benefits ASL signal with increased inherent signal-to-noise ratio (SNR) and prolonged blood T1 , which may provide improved delineation of vasculature in 4D MRA. PURPOSE: To investigate the feasibility of NCE 4D MRA using 3D Cartesian trajectory and stack-of-stars (SOS) golden angle radial trajectory at 7T...
December 12, 2017: Journal of Magnetic Resonance Imaging: JMRI
Zengpanpan Ye, Xiaolin Ai, Xin Hu, Fang Fang, Chao You
Intraventricular hemorrhage (IVH) was associated with poor outcomes in patients with intracerebral hemorrhage. IVH had a high incidence in patients with ruptured arteriovenous malformations (AVMs). In this study, we aimed to discuss the clinical features and prognostic factors of outcomes in the patients with AVM-related IVH.From January 2010 to January 2016, we collected the data of the patients with AVM-related IVH retrospectively. The data, including clinical and radiological parameters, were collected to evaluate the clinical features...
November 2017: Medicine (Baltimore)
Marian C Neidert, Michael T Lawton, Louis J Kim, John D Nerva, Kaoru Kurisu, Fusao Ikawa, Juergen Konczalla, Nazife Dinc, Volker Seifert, Julian Habdank-Kolaczkowski, Taketo Hatano, Makoto Hayase, Dino Podlesek, Gabriele Schackert, Thomas Wanet, Sven Gläsker, Christoph J Griessenauer, Christopher S Ogilvy, Andreas Kneist, Ulrich Sure, Burkhardt Seifert, Luca Regli, Oliver Bozinov, Jan-Karl Burkhardt
OBJECTIVE: The recently published arteriovenous malformation-related intracerebral haemorrhage (AVICH) score showed better outcome prediction for patients with arteriovenous malformation (AVM)-related intracerebral haemorrhage (ICH) than other AVM or ICH scores. Here we present the results of a multicentre, external validation of the AVICH score. METHODS: All participating centres (n=11) provided anonymous data on 325 patients to form the Spetzler-Martin (SM) grade, the supplemented SM (sSM) grade, the ICH score and the AVICH score...
October 6, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
Shigeru Miyachi, Takashi Izumi, Tetsu Satow, Kittipong Srivatanakul, Yasushi Matsumoto, Tomoaki Terada, Yuji Matsumaru, Hiro Kiyosue
PURPOSE: Recent reports have posed doubts about the effect of preradiosurgical embolization in brain arteriovenous malformation (AVM) because it makes the planning of stereotactic radiosurgery (SRS) difficult and has the risk of recanalization out of the target. We investigated whether the performance and quality of embolization may influence the success of SRS based on a retrospective case cohort study. MATERIALS AND METHODS: Seventy-three patients who underwent embolization followed by SRS between 2003 and 2012 in eight institutes with neurointerventionists were considered...
September 2017: Neurointervention
Tilman Schubert, Zachary Clark, Carolina Sandoval-Garcia, Ryan Zea, Oliver Wieben, Huimin Wu, Patrick A Turski, Kevin M Johnson
OBJECTIVES: The aim of this study was to assess the sensitivity and specificity of pseudo-continuous arterial spin labeling (PCASL) magnetic resonance angiography (MRA) with 3-dimensional (3D) radial acquisition for the detection of intracranial arteriovenous (AV) shunts. MATERIALS AND METHODS: A total of 32 patients who underwent PCASL-MRA, clinical magnetic resonance imaging (MRI)/MRA exam, and digital subtraction angiography (DSA) were included in this retrospective analysis...
September 20, 2017: Investigative Radiology
Mohana Rao Patibandla, Dale Ding, Hideyuki Kano, Zhiyuan Xu, John Y K Lee, David Mathieu, Jamie Whitesell, John T Pierce, Paul P Huang, Douglas Kondziolka, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
OBJECTIVE Due to the complexity of Spetzler-Martin (SM) Grade IV-V arteriovenous malformations (AVMs), the management of these lesions remains controversial. The aims of this multicenter, retrospective cohort study were to evaluate the outcomes after single-session stereotactic radiosurgery (SRS) for SM Grade IV-V AVMs and determine predictive factors. METHODS The authors retrospectively pooled data from 233 patients (mean age 33 years) with SM Grade IV (94.4%) or V AVMs (5.6%) treated with single-session SRS at 8 participating centers in the International Gamma Knife Research Foundation...
September 8, 2017: Journal of Neurosurgery
J P Mohr, Jessica R Overbey, Ruediger von Kummer, Marco A Stefani, Richard Libman, Christian Stapf, Michael K Parides, John Pile-Spellman, Ellen Moquete, Claudia S Moy, Eric Vicaut, Alan J Moskowitz, Kirsty Harkness, Charlotte Cordonnier, Alessandra Biondi, Emmanuel Houdart, Joachim Berkefeld, Catharina J M Klijn, Xavier Barreau, Helen Kim, Andreas Hartmann
OBJECTIVE: To investigate the effects of medical vs interventional management on functional outcome in A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA). METHODS: We used the initial results of a nonblinded, randomized, controlled, parallel-group trial involving adults ≥18 years of age with an unruptured brain arteriovenous malformation (AVM) to compare the effects of medical management (MM) with or without interventional therapy (IT) on functional impairment, defined by a primary outcome of death or symptomatic stroke causing modified Rankin Scale (mRS) score ≥2...
October 3, 2017: Neurology
Yu-Jie Huang, Shih-Wei Hsu, Tsair-Fwu Lee, Jih-Tsun Ho, Wu-Fu Chen
BACKGROUND: Target identification is important for radiosurgery for arteriovenous malformations (AVMs). Targets defined by different imaging modalities may be inconsistent in practice. OBJECTIVES: The goal of this study is to review and analyze the consistency between targets defined by different imaging modalities in radiosurgery for AVMs. METHODS: From March 2007 to June 2011, AVM patients for radiosurgery whose targets were delineated by angiography/computed tomography (CT)/magnetic resonance imaging (MRI) were reviewed...
2017: Stereotactic and Functional Neurosurgery
Hengwei Jin, Yuhua Jiang, Huijian Ge, Jing Luo, Conghui Li, Hongxing Wu, Youxiang Li
OBJECTIVES: Several scales have been proposed for risk assessment and outcome determination in brain arteriovenous malformations treated by endovascular therapy. We aim to validate and compare the efficacy of these scales in predicting perioperative complications and clinical outcomes. METHODS: We retrospectively reviewed brain arteriovenous malformations patients who underwent endovascular therapy at 4 centers in China from January 2012 to December 2015. The primary outcomes were complications, unfavorable outcome (mRS ≥ 3), and complete obliteration...
October 2017: World Neurosurgery
Xianli Lv, Cao Song, Hongwei He, Chuhan Jiang, Youxiang Li
Objective Transvenous retrograde arteriovenous malformation (AVM) embolization (TRAE) has been proposed. The present study was to review the techniques, their conjunctions and effectiveness. Methods Eligible related articles were identified by searching the PubMed and Web of Science databases using "transvenous" and "arteriovenous malformation." Results A total of 16 eligible studies, with 60 cases of AVM treated with TRAE, were analyzed. Prior to TRAE procedure, transarterial Onyx 18 was performed in 23 (38...
October 2017: Interventional Neuroradiology
Ashish H Shah, Anthony C Wang, Jacques J Morcos
Superficial arteriovenous malformations (AVMs) with favorable Spetzler-Martin grading are amenable to primary surgical resection. Careful preoperative workup including preoperative angiograms is essential to identify feeding artery aneurysms and deep venous drainage. The authors present a 37-year-old female who presented with a Spetzler-Martin Grade II right parietal superficial AVM with a 5-mm feeding artery aneurysm from the posterior cerebral artery. Given the risk of hemorrhage, the AVM was resected completely without any complications...
July 2017: Neurosurgical Focus
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