The natural history of unruptured intracranial arteriovenous malformations

Rd, Brown; Do, Wiebers; Forbes, Glenn S.; Wm, O'Fallon; Dg, Piepgras; Wr, Marsh; Rj, Maciunas

doi:10.3171/jns.1988.68.3.0352

Cited by 673 publications

(292 citation statements)

References 18 publications

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“…AVM sizes (mm) were measured in three dimensions, and the product of these halved, considering the ellipsoidal shape of the AVMs, to calculate their volume 7,19,20 , using the formula: V = d1 × d2 × d3 × ½ where d1, d2 and d3 are the three dimensions of the malformation in cm, and V is the volume in mm 3,7,21 .…”

Section: Endovascular Techniquesmentioning

confidence: 99%

Predictors of Total Obliteration in Endovascular Treatment of Cerebral Arteriovenous Malformations

et al. 2014

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SUMMARY -Endovascular therapy is a therapeutic option that can achieve total obliteration of cerebral arteriovenous malformations (AVMs (OR: 50.9; 0; P = 0.000), and opposing factors,(3)(4)(5)(6)4; P = 0.002) and afferences of more than two vessels of the Willis polygon (OR: 7.0; P = 0.038). An AVM diameter smaller than 3 cm is a predictive factor of total obliteration. Total postembolization obliteration persisted in 100% of the cases after 12 months.

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Section: Endovascular Techniquesmentioning

confidence: 99%

Predictors of Total Obliteration in Endovascular Treatment of Cerebral Arteriovenous Malformations

et al. 2014

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“…[1][2][3][4][5][6][7] Management of these lesions is complicated by the fact that bAVMs form a very heterogeneous group of lesions. The variable arteriovenous malformation (AVM) locations, morphologies, and angioarchitectural characteristics may impart a different risk of hemorrhage for each patient, 8 -15 requiring individualized treatment decisions.…”

mentioning

confidence: 99%

“…Reported yearly hemorrhage rates may be as low as 2% or as high as 32.6%. [2][3][4][5]7,22,23 The appropriate management of patients with AVMs can therefore vary from simple observation to aggressive multimodality treatment aimed at total AVM obliteration. 6 Because risks of treatment must be weighed against those of conservative management of bAVMs, we sought to obtain a better understanding of the natural history and factors predictive of hemorrhage in bAVM patients.…”

mentioning

confidence: 99%

The Natural History and Predictive Features of Hemorrhage From Brain Arteriovenous Malformations

Costa

Wallace

Brugge

et al. 2009

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Background and Purpose-Patients harboring brain arteriovenous malformations (bAVMs) are at a lifelong risk for hemorrhagic strokes, but the natural history is poorly understood. We examined the impact of demographic and angiographic features on the likelihood of future hemorrhage. Methods-A prospectively accrued database of bAVM patients maintained at the Toronto Western Hospital was analyzed; 678 consecutive, prospectively enrolled bAVM patients were followed for 1931.7 patient-years. The rate of hemorrhage over long-term follow-up was recorded. The impact of baseline clinical and radiographic features and partial treatment on time to hemorrhage were analyzed using survival analysis. Neurological outcome after hemorrhage was assessed using the Glasgow Outcome Score. Results-Hemorrhage rates were 4.61% per year for the entire cohort (nϭ678), 7.48% per year for bAVMs with initial hemorrhagic presentation (nϭ258), 4.16% per year for initial seizure presentation (nϭ260)

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“…9 To date, the expectant management for intracranial AVM in Wyburn-Mason or other CAMS should be approached as if it is an isolated AVM with a 2.2% per year risk of rupture in asymptomatic cases. 10 Treatment modalities described include endovascular embolization, surgical extirpation, and irradiation. …”

Section: Discussionmentioning

confidence: 99%

Wyburn-Mason Syndrome Associated with Thyroid Arteriovenous Malformation: A First Case Report

Lee¹,

Chen²,

Gailloud³

et al. 2007

American Journal of Neuroradiology

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SUMMARY:A 31-year-old woman with a prior history of Wyburn-Mason syndrome, complicated previously by a left thalamic intracerebral hemorrhage at age 21, complained of sudden left vision loss due to a central retinal vein occlusion. Angiography revealed a left thyroid arterio-venous malformation (AVM) in addition to ones found intracerebrally. The pathogenesis and embryogenesis of this finding including the management of AVMs in Wyburn-Mason syndrome are discussed. W yburn-Mason syndrome is an uncommon condition of brain-retinofacial angiomatosis resulting in multiple arteriovenous malformations (AVMs), usually on the ipsilateral side.1 Wyburn-Mason syndrome is now classified as a craniofacial arteriovenous metameric syndrome (CAMS).2 To date, thyroid AVMs with Wyburn-Mason syndrome have not been described. We describe a case of angiographically confirmed thyroid AVM in a clinically euthyroid patient with Wyburn-Mason syndrome. The embryology and possible pathogenesis, as well as management options for WyburnMason syndrome, are discussed. Case ReportA 31-year-old woman with Wyburn-Mason syndrome diagnosed at age 12 years with a known retinal AVM involving the left optic disc presented with sudden loss of vision in the left eye. Examination revealed a left central retinal vein occlusion with dilated tortuous retinal veins, optic disc swelling, and widespread retinal hemorrhages in all 4 quadrants. Her past history was significant for a left thalamic intracranial hemorrhage at age 21 years requiring a prolonged intensive care admission. She had no other neurologic symptoms.Formal 4-vessel cerebral digital subtraction angiography (DSA) was performed to evaluate the extent of her vascular malformations. It revealed a 3.0 ϫ 2.5-cm AVM in the left paramedian location along the medial aspect of the left internal carotid artery and optic tract, with an abnormal vascular blush within the left orbit and retina (Fig 1). The intracerebral AVM was fed by thalamic perforator arteries from the left posterior communicating artery (Fig 2), distal branches of the left internal carotid artery, anterior cerebral artery, and a prominent anterior choroidal artery. Incidentally, angiography also showed a left AVM of the thyroid gland (Fig 3), which is confirmed on multiple views and distinct from the laryngeal or paralaryngeal vessels. Her thyroid function tests were normal, and she has remained clinically euthyroid.Her central retinal vein occlusion was managed expectantly with regular review to monitor intraocular pressure and to observe for neovascularization. She has experienced no further hemorrhages from the AVMs in her eye, thyroid, or brain, nor has she had evidence of optic nerve compression.

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The natural history of unruptured intracranial arteriovenous malformations

Cited by 673 publications

References 18 publications

Predictors of Total Obliteration in Endovascular Treatment of Cerebral Arteriovenous Malformations

Predictors of Total Obliteration in Endovascular Treatment of Cerebral Arteriovenous Malformations

The Natural History and Predictive Features of Hemorrhage From Brain Arteriovenous Malformations

Wyburn-Mason Syndrome Associated with Thyroid Arteriovenous Malformation: A First Case Report

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