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Arteriovenous Malformations

Alberto Feletti, Stavros Dimitriadis, Stefano Vallone, Giacomo Pavesi
BACKGROUND:  Arteriovenous malformations (AVMs) of the scalp are rare and infrequently encountered by the neurosurgeon. CASE DESCRIPTION:  We report a unique case of a 42-year-old patient who presented with a progressive worsening of visual acuity in the right eye (lower quadrantanopia) and palpebral ptosis. Physical examination revealed a right exophthalmos and a right frontoparietal scalp soft swelling when the patient was in the supine position. Neurologic work-up showed a scalp AVM extending into the orbit and connected to an intraorbital cavernous angioma...
June 15, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Serrano-Rubio Alejandro, Ruiz-Treviño Armando S, Orenday-Barraza Jose M, Vázquez-Gregorio Rafael, Lee Angel, Nathal Edgar
OBJECT: The use of intraoperative fluorescence has proven to be a useful tool in multiple neurosurgical procedures with a potential utility in treating arteriovenous malformations (AVMs). The aim of this study was to characterize dynamic changes of an AVM using a microscope-integrated technique at the moment of performing an intraoperative Sodium fluorescein videoangiography (FL-VAG) at each of the resection phases. METHODS: Our study at the National Institute of Neurology and Neurosurgery-Mexico City, prospectively recruited twelve patients harboring an AVM, using FL-VAG as an ancillary technique for the resection of the lesion...
June 12, 2018: World Neurosurgery
Nicolas W Villelli, David M Lewis, Thomas J Leipzig, Andrew J DeNardo, Troy D Payner, Charles G Kulwin
OBJECTIVE Intraoperative angiography can be a valuable tool in the surgical management of vascular disorders in the CNS. This is typically accomplished via femoral artery puncture; however, this can be technically difficult in patients in the prone position. The authors describe the feasibility of intraoperative angiography via the popliteal artery in the prone patient. METHODS Three patients underwent intraoperative spinal angiography in the prone position via vascular access through the popliteal artery. Standard angiography techniques were used, along with ultrasound and a micropuncture needle for initial vascular access...
June 15, 2018: Journal of Neurosurgery. Spine
Olga Nikolaidou, Ekaterini Xinou, Pavlos Papakotoulas, Andis Philippides, Dimitra Panagiotopoulou-Boukla
Pancreatic arteriovenous malformation (pAVM) is a very rare entity, as less than 100 cases are reported in the international literature. Patients with pAVM may be asymptomatic or may present a wide range of symptoms, such as vague pain, feeling of fullness, gastrointestinal bleeding, or even portal hypertension. We present the multimodality approach in the diagnosis of a patient with pAVM and treatment via transcatheter arterial embolization of the lesion using steel coils. The patient was free of symptoms 12 months later...
April 2018: Radiology Case Reports
Suneet N Purohit, William K Cornwell, Jay D Pal, JoAnn Lindenfeld, Amrut V Ambardekar
Pulsatility seems to have a teleological role because evolutionary hierarchy favors higher ordered animals with more complex, multichamber circulatory systems that generate higher pulse pressure compared with lower ordered animals. Yet despite years of such natural selection, the modern generation of continuous-flow left ventricular assist devices (CF-LVADs) that have been increasingly used for the last decade have created a unique physiology characterized by a nonpulsatile, nonlaminar blood flow profile with the absence of the usual large elastic artery Windkessel effect during diastole...
June 2018: Circulation. Heart Failure
Elena I Fomchenko, Daniel Duran, Sheng Chih Jin, Weilai Dong, E Zeynep Erson-Omay, Prince Antwi, August Allocco, Jonathan R Gaillard, Anita Huttner, Murat Gunel, Michael L DiLuna, Kristopher T Kahle
Congenital hemangiomas are tumor-like vascular malformations with poorly understood pathogenesis. We report the case of a neonate with a massive congenital scalp hemangioma that required urgent neurosurgical removal on the second day of life due to concern for high-flow arteriovenous shunting. Exome sequencing identified a rare damaging de novo germline mutation in MYH9 (c.5308C>T, p.[Arg1770Cys]), encoding the MYH9 non-muscle myosin IIA. MYH9 has a probability of loss-of-function intolerance (pLI) score > 0...
June 14, 2018: Cold Spring Harbor Molecular Case Studies
Yi Guo, Benhong Xu, Zhenxing Sun, Youtu Wu, Wei Shi, Jin Wang, Xianbin Meng, Wei Ge, Guihuai Wang
Spinal arteriovenous malformations (sAVM) are a rare and heterogeneous group of blood vessel disorders that affect spinal cord function directly or indirectly; however, the pathogenesis of sAVM is still unclear. In this study, we compared four sAVM specimens obtained during surgery and donated control samples in a Tandem Mass Tag (TMT)-labeled proteomic analysis. We identified 3101 proteins, 654 of which were differentially expressed in sAVM samples compared with the controls. Of these, 96 proteins were upregulated and 358 proteins were downregulated...
June 11, 2018: Microvascular Research
Jaya Mary Thomas, Sumi Surendran, Mathew Abraham, Dhakshmi Sasankan, Sridutt Bhaadri, Arumugam Rajavelu, Chandrasekharan C Kartha
OBJECTIVE: Arteriovenous malformations (AVMs) are characterised by tangles of dysplastic blood vessels which shunt blood from arteries to veins with no intervening capillary bed. It is not known at what stage of development and differentiation, AVM vessels became aberrant. To address this, we have analysed the expression of vascular differentiation, vascular maturation and brain capillary specific genes in AVM nidus. METHODOLOGY: We performed immunohistochemistry and western blot analysis of vascular differentiation (HEY2, DLL4, EFNB2, and COUP-TFII), vascular maturation (ENG and KLF2) and brain capillary specific genes (GGTP and GLUT1) on ten surgically excised human brain AVMs and ten normal human brain tissues...
2018: PloS One
Whitney L Wooderchak-Donahue, Peter Johnson, Jamie McDonald, Francine Blei, Alejandro Berenstein, Michelle Sorscher, Jennifer Mayer, Angela E Scheuerle, Tracey Lewis, J Fredrik Grimmer, Gresham T Richter, Marcie A Steeves, Angela E Lin, David A Stevenson, Pinar Bayrak-Toydemir
RASA1-related disorders are vascular malformation syndromes characterized by hereditary capillary malformations (CM) with or without arteriovenous malformations (AVM), arteriovenous fistulas (AVF), or Parkes Weber syndrome. The number of cases reported is relatively small; and while the main clinical features are CMs and AVMs/AVFs, the broader phenotypic spectrum caused by variants in the RASA1 gene is still being defined. Here, we report the clinical and molecular findings in 69 unrelated cases with a RASA1 variant identified at ARUP Laboratories...
June 11, 2018: European Journal of Human Genetics: EJHG
Basil Grüter, Itai Mendelowitsch, Michael Diepers, Luca Remonda, Javier Fandino, Serge Marbacher
No abstract text is available yet for this article.
June 8, 2018: World Neurosurgery
Evan Calabrese, Arthur H Baghdanian, Ronald J Zagoria, Spencer C Behr
No abstract text is available yet for this article.
July 2018: Urology Case Reports
Christine Costa, Jérôme Massardier, Delphine Gamondes, Vincent Cottin
No abstract text is available yet for this article.
June 5, 2018: Archivos de Bronconeumología
Michael Iv, Omar Choudhri, Robert L Dodd, Shreyas S Vasanawala, Marcus T Alley, Michael Moseley, Samantha J Holdsworth, Gerald Grant, Samuel Cheshier, Kristen W Yeom
OBJECTIVE Patients with brain arteriovenous malformations (AVMs) often require repeat imaging with MRI or MR angiography (MRA), CT angiography (CTA), and digital subtraction angiography (DSA). The ideal imaging modality provides excellent vascular visualization without incurring added risks, such as radiation exposure. The purpose of this study is to evaluate the performance of ferumoxytol-enhanced MRA using a high-resolution 3D volumetric sequence (fe-SPGR) for visualizing and grading pediatric brain AVMs in comparison with CTA and DSA, which is the current imaging gold standard...
June 8, 2018: Journal of Neurosurgery. Pediatrics
Daniel Umansky, Benjamin W Corn, Ido Strauss, Natan Shtraus, Shlomi Constantini, Vladimir Frolov, Shimon Maimon, Andrew A Kanner
PURPOSE: Treatment of cerebral arteriovenous malformations (AVM)-the most common cause of stroke in the pediatric population-can be challenging due to the complexity of size, morphology, and location. There is a significant risk in comparison to AVM treatment among adults. Thus, AVM treatment in the pediatric population imposes unique challenges. Recent improvements include optimized catheter techniques and better embolization materials, such as Onyx, a non-adhesive liquid embolic agent used in the adult population...
June 7, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Ashish H Shah, Mark Osten, Lee Benson, Sami Alnasser, Yvonne Bach, Rohan Vishwanath, Alex Van De Bruaene, Healey Shulman, Jeneka Navaranjan, Rafique Khan, Eric Horlick
OBJECTIVES: The aim of this study was to assess the incidence of persistently positive results on agitated saline contrast injection after patent foramen ovale (PFO) closure, the underlying mechanism, and management. BACKGROUND: Transcatheter intervention to close a PFO is reasonable in highly selected patients younger than 60 years, after a thorough cardioneurological investigation following a cryptogenic stroke, particularly in the presence of thromboembolic disease or in patients at high risk for venous thrombosis...
June 11, 2018: JACC. Cardiovascular Interventions
Juan C Fernandez-Miranda
The medial temporal lobe can be divided in anterior, middle, and posterior segments. The anterior segment is formed by the uncus and hippocampal head, and it has extra and intraventricular structures. There are 2 main approaches to the uncohippocampal region, the anteromedial temporal lobectomy (Spencer's technique) and the transsylvian selective amygdalohippocampectomy (Yasargil's technique).In this video, we present the case of a 29-yr-old man with new onset of generalized seizures and a contrast-enhancing lesion in the left anterior segment of the medial temporal lobe compatible with high-grade glioma...
June 7, 2018: Operative Neurosurgery (Hagerstown, Md.)
Anselme Alfred Dabilgou, Julie Marie Adeline Kyelem
Vascular arteriovenous malformations (VAM) are aggressive vascular diseases associated with increased haemorrhagic risk in terms of morbidity and mortality. Vascular arteriovenous malformations are usually sporadic. The main symptom of VAM is hemorrhage, in 50% of cases. We here report the case of a 28 year old patient, hospitalized with right sided motor deficit of acute onset associated with consciousness disorder in the Department of Neurology at the Yalgado Ouédraogo University Hospital Center. The patient had a history of chronic headaches treated with self-medication and of right Bravais-Jacksonian seizures...
2018: Pan African Medical Journal
Alba Cañas, Montserrat Juncadella, Ruth Lau, Andreu Gabarrós, Mireia Hernández
The Supplementary Motor Area (SMA)-located in the superior and medial aspects of the superior frontal gyrus-is a preferential site of certain brain tumors and arteriovenous malformations, which often provoke the so-called SMA syndrome. The bulk of the literature studying this syndrome has focused on two of its most apparent symptoms: contralateral motor and speech deficits. Surprisingly, little attention has been given to working memory (WM) even though neuroimaging studies have implicated the SMA in this cognitive process...
2018: Frontiers in Psychology
A Dalton, G Dobson, M Prasad, N Mukerji
PURPOSE: Arteriovenous malformations (AVM) are still frequently described as congenital lesions in medical texts despite little evidence existing for their congenital nature. Increasing numbers of case reports of de novo AVMs add weight to the notion that they are dynamic lesions and that they can form postnatally. A thorough review of all reported cases of de novo AVM formation and a review of articles relating to AVM pathogenesis was planned to summarise current research on AVM pathogenesis and provide insight into the future implications for AVM research and treatment...
June 6, 2018: British Journal of Neurosurgery
Stéphanie Lenck, Michael Schwartz, Jin Hengwei, Ronit Agid, Patrick Nicholson, Timo Krings, Michael Tymianski, Vitor Mendes-Pereira, Ivan Radovanovic
OBJECTIVES: To assess the outcome of residual bAVM after stereotactic radiosurgery. METHODS: Following institutional review board approval, we retrospectively included patients with residual bAVM 3 years after radiosurgery. We compared the demographics, angioarchitectural characteristics, complications, bleeding and cure rates of patients with intervention or conservative management (i.e. observation). We analyzed the characteristics of patients treated conservatively who achieved cure or remained with persistent AVMs during follow-up...
June 1, 2018: World Neurosurgery
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