Arteriovenous malformations of the posterior fossa

Abstract

AVMs of the posterior fossa are reviewed on the basis of personal experience of 47 cases including 2 venous angiomas, 7 cavernous angiomas, 5 arteriovenous fistulas and 33 true arteriovenous malformations and of the few series reported in the literature. MRI is now an indispensable tool to define the exact localization of any malformation. Combined with angiography, it permits one to choose the most adequate therapeutic strategy and the best surgical approach. Radical cure is to be contemplated in most cases considering the often dramatic consequences of bleeding at the infratentorial level. Deep AVMs and moreover cavernous angiomas, even those located in highly functional structures such as the brain stem, can now be discussed for treatment. Encouraging results have already been obtained using, alone or in association, the recently advanced modalities of treatment: interventional neuroradiology, radiosurgery, and microsurgery.

Tinnitus and Cerebellar Developmental Venous Anomaly

“…A review of 24 cerebellar venous angiomas found 3 patients (12.5%) with tinnitus, which in all 3 patients was associated with vertigo and headaches. 7 Computed tomographic scans and angiograms showed large venous angiomas in the right cerebellar hemisphere, without bleeding. Tinnitus seemed to be correlated with the size of the venous angioma.…”

“…Mainly located in the depth of the cerebellum, venous angioma is the vascular malformation most frequently found at autopsy (2.6%) because it is less commonly associated with bleeding, even though cerebellar localization represents 50% of all venous angiomas associated with hematoma. [6][7][8] Most venous angiomas are asymptomatic. This malformation is an abnormal venous network that develops to compensate for the lack of important draining veins.…”

A novel proposed grading system for cerebellar arteriovenous malformations

“…35 Four articles described anatomical classifications for cerebellar AVMs, designed to aid treatment decision-making; none outlined prognostic parameters. 11,16,35,49 There are no cerebellar-specific, prognostic, clinically applicable, AVM grading systems present in the literature (Table 4).…”

“…C erebellar arteriovenous malformations (AVMs) comprise 10%-15% of all intracranial AVMs and the majority (70%) of infratentorial AVMs. 11,36 Despite being a minority of AVM cases, cerebellar AVMs represent an important subgroup of patients due to their higher risk for morbidity and mortality than supratentorial AVMs. 47 Cerebellar AVMs are unique in their natural history, having a greater annual risk for rupture and being more technically challenging to resect because of their close proximity to the brainstem and vital blood supply.…”

Arteriovenöse Malformationen in der hinteren Schädelgrube - Eine Studie an 36 Patienten

“…Symptomatische AVM in der hinteren Schadelgrube soliten deshalb, wenn moglich, kurativ behandelt werden. Das Ziel der Operation besteht in der vollstandigen Entfernung des AVM durch mikrochirurgische Techniken (12). Eine Teilresektion sollte vermieden werden, da bei hohem Operationsrisiko eine erneute Blutung nicht sicher verhindert werden kann.…”