Cerebral Arteriovenous Malformations: Evaluation and Management

Abstract

There has been increased detection of incidental AVMs as result of the frequent use of advanced imaging techniques. The natural history of AVM is poorly understood and its management is controversial. This review provides an overview of the epidemiology, pathophysiology, natural history, clinical presentation, diagnosis, and management of AVMs. The authors discussed the imaging techniques available for detecting AVMs with regard to the advantages and disadvantages of each imaging modality. Furthermore, this review paper discusses the factors that must be considered for the most appropriate management strategy (based on the current evidence in the literature) and the risks and benefits of each management option.

Medical image of the month: large complex cerebral arteriovenous malformation

“…Clinical presentations include intracranial hemorrhage, seizures, headaches and neurological deficits, with hemorrhage being the most common and significant manifestation (2). The gold standard imaging modality is conventional cerebral angiography (1). Treating an AVM is a challenging clinical problem, as the risk of treatment has to be weighed against the natural history of the condition.…”

“…Treating an AVM is a challenging clinical problem, as the risk of treatment has to be weighed against the natural history of the condition. Treatment modalities include observation with medical management, surgical resection, stereotactic radiosurgery, and endovascular embolization (1,2).…”

Treatment of cerebrovascular disease during pregnancy

“…Клинические проявления АВМ могут быть разно-образны: ВЧК (2-4%), судорожный синдром (18-40%), головная боль (5-14%), неврологическая сим-птоматика (1-40%) [4]. По данным литературы [5], частота ВЧК во время беременности из-за разрыва АВМ возрастает в 8 раз, что настораживает не только нейрохирургов и неврологов, но и акушеров-гинеко-логов.…”

Recurrent Haemorrhage due to Cerebral Arterio-venous malformation in successive Pregnancies: A rare Presentation

“…Intracranial Arteriovenous Malformations are formed from a vascular plexus of direct arterio-venous connections that lack an intervening capillary bed [1] . During pregnancy AVMs usually present with intra cerebral haemorrhage (ICH), headache, seizures or focal neurological deficit [2] .…”