Imaging of Cerebral Arteriovenous Malformations and Dural Arteriovenous Fistulas

2012 ◽  
Vol 23 (1) ◽  
pp. 27-42 ◽  
Author(s):  
Mahmud Mossa-Basha ◽  
James Chen ◽  
Dheeraj Gandhi
2013 ◽  
Vol 73 (2) ◽  
pp. ons211-ons223 ◽  
Author(s):  
Per Kristian Eide ◽  
Angelika G. Sorteberg ◽  
Torstein R. Meling ◽  
Wilhelm Sorteberg

Abstract BACKGROUND: Directional intraoperative Doppler (dioDoppler) ultrasonography is well established as a tool in the surgery of intracranial aneurysms and cerebral arteriovenous malformations. The literature provides little information about the possible usefulness of this method during surgery on cranial dural arteriovenous fistulas (dAVFs). OBJECTIVE: To present our experience with the use of dioDoppler during surgery on cranial dAVFs. METHODS: All patients undergoing craniotomy for cranial dAVF from January 2007 to October 2012 in which dioDoppler was used were included in the study. We reviewed patient records, operating protocols, radiological images, dioDoppler files, and intraoperative videos. RESULTS: During the study period, 12 patients with cranial dAVFs underwent surgical treatment facilitated by dioDoppler. Four patients were operated on acutely for cerebral bleeds, and 8 patients were treated for various cerebral symptoms and the assumption of a significant risk for intracranial bleed. Three advantages of dioDoppler were unequivocal identification of veins with cortical/deep venous reflux from the fistula, verification of completeness of occlusion of the fistula, and identification of dural arterial feeders not visualized under the microscope. CONCLUSION: Reviewing our experience, we found that dioDoppler sonography is an easy, safe, effective, reliable, and instantaneous tool during surgery on cranial dAVFs.


Author(s):  
Dominik F. Vollherbst ◽  
René Chapot ◽  
Martin Bendszus ◽  
Markus A. Möhlenbruch

Abstract Background Endovascular embolization is an effective treatment option for cerebral arteriovenous malformations (AVMs) and dural arteriovenous fistulas (DAVFs). A variety of liquid embolic agents have been and are currently used for embolization of AVMs and DAVFs. Knowledge of the special properties of the agent which is used is crucial for an effective and safe embolization procedure. Material and Methods This article describes the properties and indications of the liquid embolic agents which are currently available: cyanoacrylates (also called glues), and the copolymers Onyx, Squid and PHIL, as well as their respective subtypes. Results Cyanoacrylates were the predominantly used agents in the 1980s and 1990s. They are currently still used in specific situations, for example for the occlusion of macro-shunts, for the pressure cooker technique or in cases in which microcatheters are used that are not compatible with dimethyl-sulfoxide. The first broadly used copolymer-based embolic agent Onyx benefits from a large amount of available experience and data, which demonstrated its safety and efficacy in the treatment of cerebral vascular malformations, while its drawbacks include temporary loss of visibility during longer injections and artifacts in cross-sectional imaging. The more recently introduced agents Squid and PHIL aim to overcome these shortcomings and to improve the success rate of endovascular embolization. Novelties of these newer agents with potential advantages include extra-low viscosity versions, more stable visibility, and a lower degree of imaging artifacts. Conclusion All the available liquid embolic agents feature specific potential advantages and disadvantages over each other. The choice of the most appropriate embolic agent must be made based on the specific material characteristics of the agent, related to the specific anatomical characteristics of the target pathology.


2013 ◽  
Vol 22 (12) ◽  
pp. 904-910
Author(s):  
Hiroki Kurita ◽  
Hidetoshi Ooigawa ◽  
Ririko Takeda ◽  
Hiroyuki Nakajima ◽  
Takeshi Ogura ◽  
...  

Author(s):  
Ji Y. Chong ◽  
Michael P. Lerario

Spinal vascular malformations are rare, with dural arteriovenous fistulas (AVFs) accounting for the majority of the pathology. Unlike spinal arteriovenous malformations, which cause abrupt neurological change as a result of hemorrhage, spinal dural AVFs tend to result in a progressive myelopathy through venous congestion and cord edema. If diagnosed and treated early with endovascular embolization or microsurgery, some deficits may be reversible.


2017 ◽  
Vol 23 (5) ◽  
pp. 458-464 ◽  
Author(s):  
Giacomo Talenti ◽  
Giovanni Vitale ◽  
Giacomo Cester ◽  
Alessandro Della Puppa ◽  
Roberto Faggin ◽  
...  

Spinal vascular malformations are uncommon yet important spinal pathologies commonly classified in congenital and acquired lesions. Spinal lipomas consist of three subtypes: intramedullary lipomas, lipomyelo(meningo)celes and lipomas of the filum. Although the association of spinal arteriovenous malformations (AVM) with other congenital anomalies is well known, the coexistence of dural arteriovenous fistulas (AVF) and tethered spinal cord is exceptionally rare and only eight cases have been reported. We present two cases from our institution and speculate on the possible origin of such a rare but insidious association. We review the current literature with a focus on possible pitfalls in diagnosis and treatment.


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