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Intracranial Arterio-Venous Malformation

USU Teaching File MUTF - MedPix (2001)

View Article: MedPix Image - MedPix Topic

Affiliation: Uniformed Services University

ABSTRACT

Vascular malformations found intracranially include arterio-venous malformations (AVM), cavernous (hem)angiomas and venous angioma. AVM's are estimated to be present in 2 per 100,000 persons. They may be asymptomatic or present with neurological impairment and seizure. Symptoms often develop in young adulthood. The lesion occurs in utero and grows with the brain. Surrounded by brain parenchyma they may become symptomatic with the growth of young adulthood or adolescence. Characteristically, AVM's include a shunt of arterial blood directly to the venous circulation without intervening capillaries. This may result in a symptomatic "steal" of cerebral blood flow from adjacent tissue. The fast flowing anastomosis results in rapid clearing of contrast agents. Although MRA and contrast enhanced MRI provide anatomic and physiological insight, angiography is the gold standard for evaluation and surgical planning. No definitive management is agreed upon. Symptoms, growth, patient age and preference drive treatment. Intervential neuro-radiological techniques are aimed at occluding the blood flow with glue, coils or beads. Intra-arterial embolism may be followed by surgical excision via craniotomy. Smaller or inoperable lesions may be treated by therapeutic radiation (including stereotactic "Gammaknife") aimed at destroying the malformation. Other vascular malformations include cavernous angiomas and venous angiomas. Cavernous angiomas represent larger pools or sinusouds of slow moving blood. Hence they become bright on contrast infusion. Additionally, they often present with microhemorage and contrast extravasation. Multiple angiomas may be due to an autosomal dominant genetic inheritance and prompt examination of relatives. Venous angiomas are present in the peripheral parenchyma and often display a "stellate" topography. They represent numerous "spoke-like" venous vessels draining a larger central vein.

No MeSH data available.


T1 weighted images display a large serpingious area of flow voids in the right temporal-occpital area. It extends superiorly into the parietal area. Some mass effect is present with a right to left shift along the posterior falx. The right transverse and sigmoid sinus appear enlarged, likely due to increased outflow from the lesion.
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MPX2805_synpic604: T1 weighted images display a large serpingious area of flow voids in the right temporal-occpital area. It extends superiorly into the parietal area. Some mass effect is present with a right to left shift along the posterior falx. The right transverse and sigmoid sinus appear enlarged, likely due to increased outflow from the lesion.


Intracranial Arterio-Venous Malformation

USU Teaching File MUTF - MedPix (2001)

T1 weighted images display a large serpingious area of flow voids in the right temporal-occpital area. It extends superiorly into the parietal area. Some mass effect is present with a right to left shift along the posterior falx. The right transverse and sigmoid sinus appear enlarged, likely due to increased outflow from the lesion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2805&req=5

MPX2805_synpic604: T1 weighted images display a large serpingious area of flow voids in the right temporal-occpital area. It extends superiorly into the parietal area. Some mass effect is present with a right to left shift along the posterior falx. The right transverse and sigmoid sinus appear enlarged, likely due to increased outflow from the lesion.

View Article: MedPix Image - MedPix Topic

Affiliation: Uniformed Services University

ABSTRACT

Vascular malformations found intracranially include arterio-venous malformations (AVM), cavernous (hem)angiomas and venous angioma. AVM's are estimated to be present in 2 per 100,000 persons. They may be asymptomatic or present with neurological impairment and seizure. Symptoms often develop in young adulthood. The lesion occurs in utero and grows with the brain. Surrounded by brain parenchyma they may become symptomatic with the growth of young adulthood or adolescence. Characteristically, AVM's include a shunt of arterial blood directly to the venous circulation without intervening capillaries. This may result in a symptomatic "steal" of cerebral blood flow from adjacent tissue. The fast flowing anastomosis results in rapid clearing of contrast agents. Although MRA and contrast enhanced MRI provide anatomic and physiological insight, angiography is the gold standard for evaluation and surgical planning. No definitive management is agreed upon. Symptoms, growth, patient age and preference drive treatment. Intervential neuro-radiological techniques are aimed at occluding the blood flow with glue, coils or beads. Intra-arterial embolism may be followed by surgical excision via craniotomy. Smaller or inoperable lesions may be treated by therapeutic radiation (including stereotactic "Gammaknife") aimed at destroying the malformation. Other vascular malformations include cavernous angiomas and venous angiomas. Cavernous angiomas represent larger pools or sinusouds of slow moving blood. Hence they become bright on contrast infusion. Additionally, they often present with microhemorage and contrast extravasation. Multiple angiomas may be due to an autosomal dominant genetic inheritance and prompt examination of relatives. Venous angiomas are present in the peripheral parenchyma and often display a "stellate" topography. They represent numerous "spoke-like" venous vessels draining a larger central vein.

No MeSH data available.