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Brain AVM

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https://www.readbyqxmd.com/read/28718234/paediatrics-brain-imaging-in-epilepsy-common-presenting-symptoms-and-spectrum-of-abnormalities-detected-on-mri
#1
Azmat Ali, Faiza Akram, Ghayyur Khan, Shaukat Hussain
BACKGROUND: Epilepsy, a common neurological disorder can present at any age and has a number of aetiologies with underlying brain disease being the most common aetiology. Brain imaging becomes important and mandatory in the work up for epilepsy in localization and lateralization of the seizure focus. METHODS: This cross-sectional study was conducted in the department of Radiology Ayub Medical Teaching Institution Abbottabad from 1st March 2015 to 31st March 2016...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28712909/comparison-of-grading-scales-regarding-perioperative-complications-and-clinical-outcomes-of-brain-arteriovenous-malformations-after-endovascular-therapy-a-multicenter-study
#2
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 (bAVMs) 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 bAVM 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...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28686111/delayed-treatment-of-ruptured-brain-avms-is-it-ok-to-wait
#3
Jeffrey S Beecher, Kristopher Lyon, Vin Shen Ban, Awais Vance, Cameron M McDougall, Louis A Whitworth, Jonathan A White, Duke Samson, H Hunt Batjer, Babu G Welch
OBJECTIVE Despite a hemorrhagic presentation, many patients with arteriovenous malformations (AVMs) do not require emergency resection. The timing of definitive management is not standardized in the cerebrovascular community. This study was designed to evaluate the safety of delaying AVM treatment in clinically stable patients with a new hemorrhagic presentation. The authors examined the rate of rehemorrhage or neurological decline in a cohort of patients with ruptured brain AVMs during a period of time posthemorrhage...
July 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28681759/dose-fractionated-gamma-knife-radiosurgery-for-large-arteriovenous-malformations-on-daily-or-alternate-day-schedule-outside-the-linear-quadratic-model-proof-of-concept-and-early-results-a-substitute-to-volume-fractionation
#4
Kanchan Kumar Mukherjee, Narendra Kumar, Manjul Tripathi, Arun S Oinam, Chirag K Ahuja, Sivashanmugam Dhandapani, Rakesh Kapoor, Sushmita Ghoshal, Rupinder Kaur, Sandeep Bhatt
BACKGROUND: To evaluate the feasibility, safety and efficacy of dose fractionated gamma knife radiosurgery (DFGKRS) on a daily schedule beyond the linear quadratic (LQ) model, for large volume arteriovenous malformations (AVMs). MATERIAL AND METHODS: Between 2012-16, 14 patients of large AVMs (median volume 26.5 cc) unsuitable for surgery or embolization were treated in 2-3 of DFGKRS sessions. The Leksell G frame was kept in situ during the whole procedure. 86% (n = 12) patients had radiologic evidence of bleed, and 43% (n = 6) had presented with a history of seizures...
July 2017: Neurology India
https://www.readbyqxmd.com/read/28681273/delayed-symptomatic-haemorrhage-from-the-remnants-of-a-thalamic-arteriovenous-malformation-after-previous-angiographic-cure-with-radiotherapy
#5
Paulina Majewska, Alpha Tsui, Alexios A Adamides
In 1995 a 16-year old girl was diagnosed with a large left thalamic AVM that was considered unsuitable for microsurgical resection and was treated with radiotherapy twice, which led to angiographic cure. She re-presented 19 years after initial treatment with a symptomatic acute thalamic haemorrhage. Her digital subtraction angiography was negative for arterio-venous shunting. MRI/MRA showed cystic change with adjacent contrast enhancement in the region of the previously irradiated arteriovenous malformation...
July 5, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28669269/microsurgical-management-of-a-high-grade-brain-arteriovenous-malformation-in-the-central-lobe-after-unsuccessful-radiosurgery
#6
Jean G de Oliveira, Carlos R Massella, Carlos Vanderlei M de Holanda, Miguel Giudicissi-Filho, Luis A B Borba
The recommendation for the great majority of high-grade brain arteriovenous malformations (bAVMs) is observation, except for those patients with recurrent hemorrhages, progressive neurological deficits, steal-related symptoms, or AVM-related aneurysms, for whom intervention should be considered. These are general recommendations, and the decision should be made on an individual basis. Surgical resection of an AVM in the central lobe may cause postoperative sensorimotor deficits since this anatomical region includes the pre- and postcentral gyri on the lateral surface and the paracentral lobule on the medial surface...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28669268/introduction-to-the-supratentorial-cerebral-arteriovenous-malformation-video-supplement
#7
Robert M Starke, Felipe C Albuquerque, Michael T Lawton
It is with great pleasure that we present this Neurosurgical Focus video supplement on supratentorial cerebral arteriovenous malformations (AVMs). We were privileged to view a remarkable number of outstanding videos demonstrating current state-of-the-art management of brain AVMs using endovascular and microsurgical modalities. Careful and critical review was required to narrow down the submitted videos to a workable volume for this supplement, which reflects the excellent work being done at multiple centers with these lesions...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28669264/surgical-treatment-of-a-complex-grade-iii-spetzler-martin-posterior-temporal-arteriovenous-malformation
#8
Amrit Chiluwal, Amir R Dehdashti
Grade III Spetzler-Martin arteriovenous malformations (AVMs) are a distinct subgroup of brain AVMs. Their variety in terms of location, type of venous drainage, and size makes them the most heterogenous group in the AVM classification. The surgical risk of treatment is also variable depending on the specifics of a given Grade III AVM. In this video illustration, the authors describe the technical nuances of surgical resection of a very complex Grade III left posterior temporal AVM. According to supplementary grading, the unruptured aspect and patient age give this lesion a Grade III; therefore, the combined grading gives the patient a score of 6, which puts him at moderate risk of morbidity for surgery...
July 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28665253/the-benefit-of-radiosurgery-for-aruba-eligible-arteriovenous-malformations-a-practical-analysis-over-an-appropriate-follow-up-period
#9
Daniel A Tonetti, Bradley A Gross, Kyle M Atcheson, Brian T Jankowitz, Hideyuki Kano, Edward A Monaco, Ajay Niranjan, John C Flickinger, L Dade Lunsford
OBJECTIVE The authors of this study found that, given the latency period required for arteriovenous malformation (AVM) obliteration after stereotactic radiosurgery (SRS), a study with limited follow-up cannot assess the benefit of SRS for unruptured AVMs. METHODS The authors reviewed their institutional experience with "ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)-eligible" AVMs treated with SRS between 1987 and 2016, with the primary outcome defined as stroke (ischemic or hemorrhagic) or death (AVM related or AVM unrelated)...
June 30, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28652950/highlights-on-cerebral-arteriovenous-malformation-treatment-using-combined-embolization-and-stereotactic-radiosurgery-why-outcomes-are-controversial
#10
REVIEW
Faustina N A Sackey, Nathaneal R Pinsker, Benjamin N Baako
Cerebral arteriovenous malformations (AVMs) are abnormal tangling between brain arteries and veins causing an arteriovenous shunt called nidus with an intervening network of vessels from the region of formation and spans through the brain. AVM effect is debilitating to the affected individual due to associated persistent intracerebral hemorrhage, resulting in significant occurrences of seizures and neurological damage. Recent innovative treatments involve a combination of embolization (Embo) procedures followed by stereotactic radiosurgery (SRS), designed to optimize less-invasive practice for the obliteration of the AVMs...
May 22, 2017: Curēus
https://www.readbyqxmd.com/read/28625906/the-impact-of-associated-nidal-lesions-in-outcome-of-brain-arteriovenous-malformations-after-radiosurgery-with-or-without-embolization
#11
Carlos Michel A Peres, Evandro Cesar de Souza, Manoel Jacobsen Teixeira, Eberval G Figueiredo, Jose Guilherme M P Caldas
BACKGROUND: Radiosurgery is a valuable option to treat arteriovenous malformations. There are correlations between some morphological nidal features and final results, and the benefits of preradiosurgical embolization have not been well established thus far. METHODS: Analysis of a longitudinal cohort of 47 consecutive patients who underwent radiosurgery with or without previous embolization. Embolizations were performed exclusively with n-butyl cyanoacrylate. Radiosurgery was delivered either as a single or divided in up to 5 equal fractions...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28608633/asymptomatic-pulmonary-arteriovenous-malformations-in-children-with-hereditary-hemorrhagic-telangiectasia
#12
Ashley M Gefen, Andrew J White
BACKGROUND: Children with Hereditary Hemorrhagic Telangiectasia (HHT) may have pulmonary arteriovenous malformations (AVMs), which can lead to symptoms of shortness of breath, exercise intolerance, clubbing, cyanosis and hemoptysis. However, some patients with pulmonary AVMs may be asymptomatic, placing them at risk for complications such as stroke or brain abscess if they are not identified and treated. This study examines the incidence of signs and symptoms associated with pulmonary AVMs in children with HHT known to have pulmonary AVMs...
June 13, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28608353/-causes-of-hospital-mortality-due-to-brain-haemorrhage-in-patients-with-arteriovenous-malformation
#13
J Vilalta, F Arikan, R Torne, R Najarro, D Lopez, A Rodriguez-Hernandez, D Gandara, P Banos
AIM: To determine the causes of mortality in cases of brain haemorrhage among patients with arteriovenous malformations (AVM) treated in a tertiary hospital. PATIENTS AND METHODS: The patients with AVM who died over the period 1990-2014 were selected from a prospective register of vascular malformations. Demographic aspects, localisation of the AVM, associated aneurysms and previous treatments were reviewed. Three main causes of death were established: initial bleeding/rebleeding, those related with the treatment of the AVM and other causes not related with AVM...
June 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28603431/hereditary-hemorrhagic-telangiectasia-and-pregnancy-potential-adverse-events-and-pregnancy-outcomes
#14
REVIEW
Omar Bari, Philip R Cohen
Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant condition with a prevalence of ~1 in 5,000 individuals. The pathophysiology of this condition centers on the lack of capillary beds between arterioles and venules, leading to direct contact between these vessels. This results in telangiectases on characteristic locations such as the face, fingers, mouth, and nasal mucosa. Visceral arteriovenous malformations (AVMs) are also observed in many patients, and these are most commonly seen in the brain, gastrointestinal tract, and lungs...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28600483/extending-the-indications-for-transvenous-approach-embolization-for-superficial-brain-arteriovenous-malformations
#15
Dinark Conceição Viana, Luis Henrique de Castro-Afonso, Guilherme Seizem Nakiri, Lucas Moretti Monsignore, Felipe Padovani Trivelato, Benedicto Oscar Colli, Daniel Giansante Abud
INTRODUCTION: Transarterial embolization is the standard endovascular treatment strategy for intracranial arteriovenous malformations (AVMs). The transvenous approach has been indicated for the embolization of deep AVMs meeting a set of strict eligibility criteria. The present study aims to assess the safety and efficacy of the transvenous approach for superficial AVMs. METHODS: A retrospective series of 12 patients presenting with cortical AVMs were treated by endovascular embolization using a transvenous approach with a curative intent...
June 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28555270/critical-review-of-brain-avm-surgery-surgical-results-and-natural-history-in-2017
#16
REVIEW
Michael Kerin Morgan, Andrew Stewart Davidson, Nazih N A Assaad, Marcus Andrew Stoodley
BACKGROUND: An understanding of the present standing of surgery, surgical results and the role in altering the future morbidity and mortality of untreated brain arteriovenous malformations (bAVMs) is appropriate considering the myriad alternative management pathways (including radiosurgery, embolization or some combination of treatments), varying risks and selection biases that have contributed to confusion regarding management. The purpose of this review is to clarify the link between the incidence of adverse outcomes that are reported from a management pathway of either surgery or no intervention with the projected risks of surgery or no intervention...
May 29, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28552161/multimodality-management-of-cerebral-arteriovenous-malformations
#17
Mohan Narayanan, Gursant S Atwal, Peter Nakaji
Arteriovenous malformations (AVMs) of the brain are diverse lesions that vary widely in location, size, and complexity. Treatment options for AVMs are correspondingly complex. Complete elimination of an AVM is required to protect patients from future hemorrhage. Decisions about whether to treat and, if so, how to treat these lesions depend on the characteristics of the patient and the specific characteristics of the AVMs. The characteristics of AVMs are often summarized through grading systems. Some AVMs can be managed conservatively, whereas others can be managed with microsurgical resection, radiosurgical ablation, or endovascular embolization, either individually or in combination...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28552160/radiosurgery-for-the-management-of-cerebral-arteriovenous-malformations
#18
Dale Ding, Robert M Starke, Jason P Sheehan
Cerebral arteriovenous malformations (AVMs) are rare, unstable vascular lesions which spontaneously rupture at a rate of approximately 2-4% annually. Stereotactic radiosurgery is a minimally invasive treatment for AVMs, with a favorable risk-to-benefit profile in most patients, with respect to obliteration, hemorrhage, and seizure control. Radiosurgery is ideally suited for small to medium-sized AVMs (diameter <3cm or volume <12cm(3)) located in deep or eloquent brain regions. Obliteration is ultimately achieved in 70-80% of cases and is directly associated with nidus volume and radiosurgical margin dose...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28552158/epidemiology-genetics-pathophysiology-and-prognostic-classifications-of-cerebral-arteriovenous-malformations
#19
Alp Ozpinar, Gustavo Mendez, Adib A Abla
Arteriovenous malformations (AVMs) are vascular deformities involving fistula formation of arterial to venous structures without an intervening capillary bed. Such anomalies can prove fatal as the high arterial flow can disrupt the integrity of venous walls, thus leading to dangerous sequelae such as hemorrhage. Diagnosis of these lesions in the central nervous system can often prove challenging as intracranial AVMs represent a heterogeneous vascular pathology with various presentations and symptomatology. The literature suggests that most brain AVMs (bAVMs) are identified following evaluation of the etiology of acute cerebral hemorrhage, or incidentally on imaging associated with seizure or headache workup...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28552157/surgical-management
#20
Michael K Morgan
Surgical management includes selection of patients for surgery, performing the technical procedure of brain arteriovenous malformation (bAVM) resection and perioperative management that maximize the chance for the best outcome. In general the Spetzler-Ponce class (SPC) can divide patients into those with good evidence that surgery is appropriate in most cases (SPC A), those in whom surgery should only be considered occasionally with highly nuanced indications (SPC C), and surgery may be appropriate having made a detailed analysis of patient (including age), clinical (including mode of presentation), and AVM characteristics (including diffuseness), and a comparative analysis of outcomes with alternate management pathways for SPC B cases...
2017: Handbook of Clinical Neurology
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