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Management of intracranial arteriovenous malformations

Abstract

Intracranial arteriovenous malformations (AVMs) are congenital lesions that can cause serious neurological deficits or even death. They can manifest as intracranial hemorrhage, epileptic seizure, or other symptoms such as headache or tinnitus. They are detected by computed tomography or magnetic resonance imaging. Recently there have been significant developments in the management of AVMs. In this paper, the authors represent an overview of the epidemiology of AVMs and the existing treatment strategies. AVMs are ideally excised by standard microsurgical techniques. The grading scale which was proposed by Spetzler and Martin is widely used to estimate the risk of direct surgery. Stereotactic radiosurgery such as that using a gamma knife is very useful for small lesions located in eloquent areas. Technological advances in endovascular surgery have provided new alternatives in the treatment of AVMs. Currently indications for embolization can be divided into presurgical embolization in large AVMs to occlude deep arterial feeding vessels and embolization before stereotactic radiosurgery to reduce the size of the nidus. Palliative embolization can be also applied for patients with large, inoperable AVMs who are suffering from progressive neurological deficits secondary to venous hypertension and/or arterial steal phenomenon. (author)
Authors:
Miyamoto, Susumu; Takahashi, Jun C [1] 
  1. National Cardiovascular Center, Suita, Osaka (Japan)
Publication Date:
Oct 15, 2008
Product Type:
Journal Article
Resource Relation:
Journal Name: Brain and Nerve; Journal Volume: 60; Journal Issue: 10
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BLOOD FLOW; CAROTID ARTERIES; CEREBRAL ARTERIES; CEREBRAL CORTEX; CONGENITAL MALFORMATIONS; EPILEPSY; MANAGEMENT; NMR IMAGING; PATIENTS; POSITRON COMPUTED TOMOGRAPHY; REVIEWS; SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY; SPIN-SPIN RELAXATION; THREE-DIMENSIONAL CALCULATIONS; VEINS
OSTI ID:
21127384
Country of Origin:
Japan
Language:
Japanese
Other Identifying Numbers:
Journal ID: ISSN 1881-6096; NOTOA6; TRN: JP0900382009015
Submitting Site:
INIS
Size:
page(s) 1103-1113
Announcement Date:
Feb 26, 2009

Citation Formats

Miyamoto, Susumu, and Takahashi, Jun C. Management of intracranial arteriovenous malformations. Japan: N. p., 2008. Web.
Miyamoto, Susumu, & Takahashi, Jun C. Management of intracranial arteriovenous malformations. Japan.
Miyamoto, Susumu, and Takahashi, Jun C. 2008. "Management of intracranial arteriovenous malformations." Japan.
@misc{etde_21127384,
title = {Management of intracranial arteriovenous malformations}
author = {Miyamoto, Susumu, and Takahashi, Jun C}
abstractNote = {Intracranial arteriovenous malformations (AVMs) are congenital lesions that can cause serious neurological deficits or even death. They can manifest as intracranial hemorrhage, epileptic seizure, or other symptoms such as headache or tinnitus. They are detected by computed tomography or magnetic resonance imaging. Recently there have been significant developments in the management of AVMs. In this paper, the authors represent an overview of the epidemiology of AVMs and the existing treatment strategies. AVMs are ideally excised by standard microsurgical techniques. The grading scale which was proposed by Spetzler and Martin is widely used to estimate the risk of direct surgery. Stereotactic radiosurgery such as that using a gamma knife is very useful for small lesions located in eloquent areas. Technological advances in endovascular surgery have provided new alternatives in the treatment of AVMs. Currently indications for embolization can be divided into presurgical embolization in large AVMs to occlude deep arterial feeding vessels and embolization before stereotactic radiosurgery to reduce the size of the nidus. Palliative embolization can be also applied for patients with large, inoperable AVMs who are suffering from progressive neurological deficits secondary to venous hypertension and/or arterial steal phenomenon. (author)}
journal = []
issue = {10}
volume = {60}
place = {Japan}
year = {2008}
month = {Oct}
}