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AVM, Arterio-venous Malformation, Vascular malformation

Smirniotopoulos, M.D. JGSM - MedPix (1988)

View Article: MedPix Image - MedPix Topic

Affiliation: Uniformed Services University

ABSTRACT

• Incidence: 0.14% • Pial/Parenchmal 70-93% supratentorial • Symptomatic at 20-40yrs (80% Dx by age 40) • Presentation: - 50% w/intracerebral hemorrhage - 33% w/SAH - 25% w/Sz (more common w/superficial lesions) • Bleeding and re-bleeding: - Incidence of 1st bleed is 3%/yr - Rebleed rate of 6% in 12 months - Rebleed 3%/yr after first year • Mortality: 10-17% • Morbidity: 10% • Nidus - dilated vascular loops with abnormal arterial to venous connection Dilated Arterial feeders, abnormal arterial collaterals and aneurysms on feeding vessels Dilated Venous drainage and varices (may act as a mass) Intervening neural tissue (gliotic/ischemic)between vessels Angiography: 85% Pial (pial feeders) 15% Dural (dural feeders, usually acquired) Intra-nidus aneurysms - a source of bleeding • Ischemic Sx when CBF drops below 15-18 ml/100gm/min • MetHgb (T1 bright): lasts for mo-yrs. • Hemosiderin (T2 dark): lasts for years, preferential T2 shortening, present in 63% (SE) and 95% (GRE) of AVM's • Hemosiderosis: meningeal staining from recurrent SAH - subfrontal, temporal, pofo (near petrous apex) - • INCREASED RISK OF BLEED: central/deep venous drainage intranidal aneurysm periventricular location • LOWER RISK OF BLEED: angiomatous change (mult dilated cortical aa. feeders) • TREATMENT: Embolization, excision, radiation isobutyl-2-cyanoacrylate/iophendylate (Pantopaque) is bright on T1W Radiation - proton-beam and stereotaxic More on AVM - http://www.ninds.nih.gov/disorders/avms/avms.htm

No MeSH data available.


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AVM, Arterio-venous Malformation, Vascular malformation

Smirniotopoulos, M.D. JGSM - MedPix (1988)

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2751&req=5

View Article: MedPix Image - MedPix Topic

Affiliation: Uniformed Services University

ABSTRACT

• Incidence: 0.14% • Pial/Parenchmal 70-93% supratentorial • Symptomatic at 20-40yrs (80% Dx by age 40) • Presentation: - 50% w/intracerebral hemorrhage - 33% w/SAH - 25% w/Sz (more common w/superficial lesions) • Bleeding and re-bleeding: - Incidence of 1st bleed is 3%/yr - Rebleed rate of 6% in 12 months - Rebleed 3%/yr after first year • Mortality: 10-17% • Morbidity: 10% • Nidus - dilated vascular loops with abnormal arterial to venous connection Dilated Arterial feeders, abnormal arterial collaterals and aneurysms on feeding vessels Dilated Venous drainage and varices (may act as a mass) Intervening neural tissue (gliotic/ischemic)between vessels Angiography: 85% Pial (pial feeders) 15% Dural (dural feeders, usually acquired) Intra-nidus aneurysms - a source of bleeding • Ischemic Sx when CBF drops below 15-18 ml/100gm/min • MetHgb (T1 bright): lasts for mo-yrs. • Hemosiderin (T2 dark): lasts for years, preferential T2 shortening, present in 63% (SE) and 95% (GRE) of AVM's • Hemosiderosis: meningeal staining from recurrent SAH - subfrontal, temporal, pofo (near petrous apex) - • INCREASED RISK OF BLEED: central/deep venous drainage intranidal aneurysm periventricular location • LOWER RISK OF BLEED: angiomatous change (mult dilated cortical aa. feeders) • TREATMENT: Embolization, excision, radiation isobutyl-2-cyanoacrylate/iophendylate (Pantopaque) is bright on T1W Radiation - proton-beam and stereotaxic More on AVM - http://www.ninds.nih.gov/disorders/avms/avms.htm

No MeSH data available.