Intracranial arteriovenous malformation: relationships between clinical and radiographic factors and ipsilateral steal severity

Journal Article · Thu Sep 01 04:00:00 EDT 1988 · Neurosurgery; (United States)

DOI:https://doi.org/10.1227/00006123-198809000-00006· OSTI ID:6326359

Batjer, H H; Devous, Sr, M D; Seibert, G B; Purdy, P D; Ajmani, A K; Delarosa, M; Bonte, F J

Intracranial arteriovenous malformations (AVMs) are high flow shunts that may jeopardize the perfusion of adjacent tissue. Clinical and radiographic data from 62 patients were analyzed to determine their relationship to the severity of steal measured by single photon emission computed tomography (SPECT). The ipsilateral steal index (ISteal(i)) was determined by dividing regional cerebral blood flow (rCBF) values within hand-drawn regions of hypoperfusion in the ipsilateral hemisphere by total brain flow, which was calculated as the average rCBF of each hemisphere. Of the patients, 40% were less than 30 years of age, 45% were 30 to 50 years old, and 15% were over 50. Forty-eight per cent presented with hemorrhage and 34% presented with progressive deficits. There was angiographic steal in 37%, and postoperative hyperemic complications developed in 21%. All patients had ipsilateral regions of hypoperfusion. The ISteal(i) was less than 0.7 in 23 (37%), 0.7 to 0.8 in 20 (32%), and greater than 0.8 in 19 (31%). The ISteal(i) was significantly less severe in the patients over 50; 78% of these patients had an ISteal(i) of greater than 0.8 (P less than 0.01). A history of hemorrhage was associated with less severe steal than that in patients who had not bled (P = 0.088). Patients presenting with a history of progressive deficits had increased severity of steal compared with those without progressive deficits (P less than 0.05). A trend toward decreased severity of steal was noted in patients with unfavorable outcomes.

• Research Organization: Univ. of Texas Southwestern Medical Center, Dallas (USA)
• OSTI ID: 6326359
• Journal Information: Neurosurgery; (United States), Journal Name: Neurosurgery; (United States) Vol. 23:3; ISSN NRSRD
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ANIMAL TISSUES
ARTERIES
BLOOD FLOW
BLOOD VESSELS
BODY
BRAIN
CARDIOVASCULAR SYSTEM
CENTRAL NERVOUS SYSTEM
COMPUTERIZED TOMOGRAPHY
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
EMISSION COMPUTED TOMOGRAPHY
HEMORRHAGE
MALFORMATIONS
NERVOUS SYSTEM
ORGANS
PATHOLOGICAL CHANGES
PATIENTS
PERFUSED TISSUES
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
SYMPTOMS
TISSUES
TOMOGRAPHY
VASCULAR DISEASES
VEINS