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Keywords:
Interventional vascular, Neuroradiology brain, Vascular, Catheter arteriography, Embolisation, Arteriovenous malformations
Authors:
M. H. J. Voormolen1, T. Menovsky1, T. Van der Zijden1, D. Berghmans2, T. Van Havenbergh2, P. M. Parizel1; 1Antwerp (Edegem)/BE, 2Wilrijk/BE
DOI:
10.1594/ecr2014/C-0831
Methods and materials
Cerebral arteriovenous malformations (cAVM) are high risk vascular lesions that are difficult to treat.
If possible,
combined (endovascular and (radio-)surgical) approaches to completely remove the cAVM is advocated.
From 2010 until 2013,
19 cAVMs in 19 patients (11 female,
8male; mean/median age 35 years (range 11-57)) were treated in our hospital by endovascular occlusion followed by surgical resection.
Presentation of the patients: epilepsy (n=8),
bleeding (n=6),
neurological deficit (n=2),
haedaches (n=1), and incidental finding (n=2).
The cAVMs were located in peripheral,
surgically resectable brain locations in the cerebral hemispheres (18) and cerebellum (1).
Sizes ranged from 2 to 15 cm (mean/median 4 cm).
Spetzler Martin grading: 1 (n=4),
2 (n=8),
3 (n=4) and 4 (n=4).
In 4 patients,
intracranial flowaneurysms were present.
patient |
sex |
age |
symptoms |
location |
size
(cm)
|
Spetzler-Martin grade |
1 |
male |
35 |
epilepsy |
right parietal |
4 |
2 |
2 |
female |
57 |
epilepsy |
left temporal |
4 |
2 |
3 |
female |
19 |
epilepsy |
left occipital |
4 |
2 |
4 |
male |
39 |
epilepsy |
right temporal |
2,5 |
1 |
5 |
male |
15 |
bleeding |
left temporal |
4 |
2 |
6 |
male |
42 |
bleeding |
right parietal |
4 |
2 |
7 |
female |
24 |
aphasia |
left frontal |
4,5 |
3 |
8 |
female |
35 |
epilepsy |
left frontal |
7 |
4 |
9 |
male |
11 |
incidental |
left frontal |
2 |
2 |
10 |
female |
51 |
incidental |
left frontal |
2 |
1 |
11 |
female |
35 |
epilepsy |
left frontal |
6 |
3 |
12 |
male |
46 |
headaches |
right frontal |
4 |
2 |
13 |
female |
20 |
epilepsy |
right frontal |
6,5 |
3 |
14 |
male |
51 |
bleeding |
right temporal |
4,5 |
2 |
15 |
female |
42 |
bleeding |
left frontal |
6,5 |
4 |
16 |
male |
25 |
bleeding |
left frontal |
15 |
4 |
17 |
female |
18 |
epilepsy |
left frontal |
2 |
1 |
18 |
female |
27 |
aphasia |
right frontal |
5 |
2 |
19 |
female |
26 |
bleeding |
right cerebellar |
4 |
4 |
Patients with cAVM treated with preoperative embolisation