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Brain AVM

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https://www.readbyqxmd.com/read/28917252/stereotactic-radiosurgery-of-the-brain-a-review-of-common-indications
#1
Philip Gilbo, Isabella Zhang, Jonathan Knisely
Over the past half-century since Lars Leksell first utilized radiation to address deep and difficult to treat lesions of the central nervous system (CNS), intracranial stereotactic radiosurgery (SRS) has become an increasingly valued tool in the hands of neurosurgeons and radiation oncologists. Following developments in medical imaging and radiation technology, radiosurgery has evolved from its first application in movement disorders to widespread use for a varied range of malignant and benign conditions. SRS remains a powerful, minimally invasive instrument that offers additional options for intervention to a diverse patient population...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28906387/a-nearly-full-recovery-from-avm-hemorrhagic-stroke-17-years-after-insult-using-a-new-integrated-neurodevelopmental-approach-a-case-report
#2
Alberto J Friedmann
RATIONAL: With the prevalence of stroke increasing in the USA and the world along with increased survival and longevity due to medical advancements, it has become increasingly necessary to look at the chronic phase of stroke recovery. Previous paradigms of stroke treatment have proven ineffective when looking at 10, 15, or 20 years of survival post insult. PATIENT CONCERNS: The patient, being a young man just out of high school, was concerned with his overall morbidity...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28878048/functional-impairments-for-outcomes-in-a-randomized-trial-of-unruptured-brain-avms
#3
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, Karin 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...
September 6, 2017: Neurology
https://www.readbyqxmd.com/read/28871374/clinical-outcomes-and-radiosurgical-considerations-for-pediatric-arteriovenous-malformation-influence-of-clinical-features-on-obliteration-rate
#4
Chang Kyu Park, Seok Keun Choi, Sung Ho Lee, Man Kyu Choi, Young Jin Lim
PURPOSE: Gamma knife radiosurgery (GKRS) is an established treatment modality for brain arteriovenous malformation (AVM), but there have been few published studies examining the relationship between clinical features of AVM and successful obliteration with GKRS in pediatric patients. In the current study, we investigate the outcomes of GKRS for pediatric patients with brain AVM and analyze the variables that influence obliteration. METHODS: We analyzed 68 pediatric patients (≤ 18 years) with a mean follow-up period of 61...
September 4, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28862547/the-treatment-of-brain-avms-study-tobas-an-all-inclusive-framework-to-integrate-clinical-care-and-research
#5
Elsa Magro, Jean-Christophe Gentric, André Lima Batista, Marc Kotowski, Chiraz Chaalala, David Roberge, Alain Weill, Christian Stapf, Daniel Roy, Michel W Bojanowski, Tim E Darsaut, Ruby Klink, Jean Raymond
OBJECTIVE The management of brain arteriovenous malformations (bAVMs) remains controversial. The Treatment of Brain AVMs Study (TOBAS) was designed to manage patients with bAVMs within a clinical research framework. The objective of this study was to study trial feasibility, recruitment rates, patient allocation to the various management groups, and compliance with treatment allocation. METHODS TOBAS combines two randomized care trials (RCTs) and a registry. Designed to be all-inclusive, the study offers randomized allocation of interventional versus conservative management to patients eligible for both options (first RCT), a second RCT testing the role of preembolization as an adjunct to surgery or radiotherapy, and a registry of patients managed using clinical judgment alone...
September 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28855391/higher-flow-is-present-in-unruptured-arteriovenous-malformations-with-silent-intralesional-microhemorrhages
#6
Xiaolin Chen, Daniel L Cooke, David Saloner, Jeffrey Nelson, Hua Su, Michael T Lawton, Christopher Hess, Tarik Tihan, Yuanli Zhao, Helen Kim
BACKGROUND AND PURPOSE: Silent microhemorrhage (hemosiderin) has been observed in resected brain arteriovenous malformations (bAVM) tissue and may represent a subgroup at increased risk for clinical hemorrhage. Previous studies suggest that ruptured bAVMs have faster flow and shorter mean transit time of contrast in blood vessels than unruptured bAVMs. We hypothesized that flow would be faster in unruptured AVMs with hemosiderin compared with those without hemosiderin. METHODS: We selected unruptured, supratentorial bAVMs >3...
August 30, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28810087/multiple-pulmonary-arteriovenous-malformations-an-unusual-cause-of-shortness-of-breath-and-recurrent-strokes
#7
Kalyan C Potu, Shenjing Li, Shawn C Kelly, Julia A Prescott-Focht, Scott Pham
OBJECTIVE: To discuss an uncommon case of a patient with multiple pulmonary arteriovenous malformations (PAVMs) presenting with dyspnea on exertion and recurrent strokes. BACKGROUND: A 79-year-old woman with recent onset recurrent cerebrovascular accidents (CVAs) was referred to cardiology for evaluation of dyspnea on exertion. Clinical examination was unrevealing. METHODS: A transthoracic echocardiogram (TTE) with agitated saline was suggestive of an extra-cardiac shunt...
February 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28802071/microrna-137-and-195-inhibit-vasculogenesis-in-brain-arteriovenous-malformations
#8
Jun Huang, Jianping Song, Meijie Qu, Yang Wang, Qinzhu An, Yaying Song, Wei Yan, Bingshun Wang, Xiaojin Wang, Song Zhang, Xi Chen, Bing Zhao, Peixi Liu, Tongyi Xu, Zhijun Zhang, David A Greenberg, Yongting Wang, Pingjin Gao, Wei Zhu, Guo-Yuan Yang
OBJECTIVES: Brain arteriovenous malformations (AVMs) are the most common cause of non-traumatic intracerebral hemorrhage in young adults. The genesis of brain AVM remains enigmatic. We investigated microRNA (miRNA) expression and its contribution to the pathogenesis of brain AVMs. METHODS: We used a large-scale miRNA analysis on 16 samples including AVMs, hemangioblastoma, and controls to identify a distinct AVM miRNA signature. AVM smooth muscle cells (AVMSMCs) were isolated and identified by flow cytometry and immunohistochemistry and candidate miRNAs were then tested in these cells...
August 12, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28796572/endoglin-and-alk1-as-therapeutic-targets-for-hereditary-hemorrhagic-telangiectasia
#9
Lidia Ruiz-Llorente, Eunate Gallardo-Vara, Elisa Rossi, David M Smadja, Luisa M Botella, Carmelo Bernabeu
Hereditary Haemorrhagic Telangiectasia (HHT) is as an autosomal dominant trait characterized by frequent nose bleeds, mucocutaneous telangiectases, arteriovenous malformations (AVMs) of the lung, liver and brain, and gastrointestinal bleedings due to telangiectases. HHT is originated by mutations in genes whose encoded proteins are involved in the transforming growth factor β (TGF-β) family signalling of vascular endothelial cells. In spite of the great advances in the diagnosis as well as in the molecular, cellular and animal models of HHT, the current treatments remain just at the palliative level...
August 20, 2017: Expert Opinion on Therapeutic Targets
https://www.readbyqxmd.com/read/28775059/basal-ganglia-t1-hyperintensity-in-hereditary-hemorrhagic-telangiectasia
#10
A Parvinian, V N Iyer, B S Pannu, D R Apala, C P Wood, W Brinjikji
BACKGROUND AND PURPOSE: The implications of basal ganglia T1 hyperintensity remain unclear in patients with hereditary hemorrhagic telangiectasia. This study was performed to assess the prevalence of this imaging finding in a large cohort of patients with hereditary hemorrhagic telangiectasia and to identify any association between this phenomenon and other disease manifestations. MATERIALS AND METHODS: In this retrospective study, we identified all patients at our institution diagnosed with definite hereditary hemorrhagic telangiectasia from 2001 to 2017...
August 3, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28764614/quantitative-evaluation-of-arteriovenous-malformation-hemodynamic-changes-after-endovascular-treatment-using-parametric-color-coding-a-case-series-study
#11
Rodrigo Rivera, Juan G Sordo, Daniel Echeverria, Lautaro Badilla, Camila Pinto, Catalina Merino-Osorio
Background Brain arteriovenous malformations (AVMs) are complex vascular lesions. Endovascular treatment results are usually measured by calculating the volume reduction of the lesions. Nevertheless, vascular flow quantification seems a more physiologically accurate way of measuring endovascular results. We evaluated the use of parametric color coding (PCC) with digital subtraction angiography (DSA), in order to determine the feasibility of PCC to detect and measure the impact of AVM endovascular treatment-induced changes using real-time hemodynamic parameters...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28735125/management-of-arteriovenous-malformations-associated-with-developmental-venous-anomalies-a-literature-review-and-report-of-two-cases
#12
Michael Zhang, Ian D Connolly, Mario K Teo, George Yang, Robert Dodd, Michael Marks, Mario Zuccarello, Gary K Steinberg
OBJECTIVE: Cerebrovascular malformation classification has revealed intermediary lesions that warrant further review due to their unusual presentation and management. We present two cases of arteriovenous malformations (AVMs) associated with a developmental venous anomaly (DVA), and discuss the efficacy of previously published management strategies. METHODS: Two cases of AVMs associated with DVA were identified and a literature search for published cases between 1980 and 2016 was conducted...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28718234/paediatrics-brain-imaging-in-epilepsy-common-presenting-symptoms-and-spectrum-of-abnormalities-detected-on-mri
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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