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Brain Arteriovenous Malformations : Pathogenesis, Epidemiology, Diagnosis, Treatment and Outcome.

Benes, Vladimír.

Brain Arteriovenous Malformations : Pathogenesis, Epidemiology, Diagnosis, Treatment and Outcome. - 1st ed. - 1 online resource (239 pages)

Intro -- Contents -- 1: Introduction -- 1.1 General Notes Regarding AVM -- 1.1.1 Historical Note -- 1.1.2 Delineation of the Area of the Disease -- References -- 2: AVM Definition and Angioarchitecture -- 2.1 Summary -- 2.2 Feeding Arteries -- 2.3 Associated Aneurysms -- 2.4 Nidus Component -- 2.5 Draining Veins -- 2.6 Venous High-Flow Angiopathy -- 2.7 Embryology: Vasculogenesis and Angiogenesis -- 2.8 Key Points -- References -- 3: Genetics of Arteriovenous Malformations -- 3.1 Summary -- 3.2 Introduction -- 3.3 Inherited AVMs -- 3.3.1 Capillary Malformation-Arteriovenous Malformation -- 3.3.2 Hereditary Hemorrhagic Telangiectasia -- 3.3.3 PTEN Hamartoma Tumor Syndrome (PHTS) -- 3.3.4 Other Rare Familial Forms of Fast-Flow Lesions -- 3.4 Sporadic AVMs -- 3.5 Signaling Pathways of AVMs -- 3.5.1 TGFβ Pathway and AVMs -- 3.5.2 NOTCH Pathway and AVMs -- 3.5.3 EPHRIN Pathway and AVMs -- 3.5.4 Mitogen-Activated Protein Kinase (MAPK) and Phosphoinositide 3-Kinase (PI3K), and AVMs -- 3.6 Conclusions -- 3.7 Key Points -- References -- 4: Epidemiology and Natural History of AVMs -- 4.1 Summary -- 4.2 Introduction -- 4.3 Epidemiology -- 4.3.1 Incidence -- 4.3.2 Prevalence -- 4.3.3 Long-Term Mortality -- 4.4 Clinical Presentation -- 4.4.1 Hemorrhagic Stroke -- 4.4.2 Epilepsy -- 4.4.3 Other Types of Presentation -- 4.5 Risk of Hemorrhage -- 4.6 Key Points -- References -- 5: Pathophysiological Principles of Cerebral Arteriovenous Malformations -- 5.1 Summary -- 5.2 Introduction -- 5.3 Chronological History of AVMs -- 5.4 Cellular Pathology and Genetics of Cerebral AVMs -- 5.5 Natural History and Clinical Presentation -- 5.6 Pathophysiology of AVMs -- 5.6.1 Arterial Hemodynamics of AVMs -- 5.6.2 Nidus and Intranidal Aneurysms -- 5.6.3 Venous Hemodynamics of AVMs. 5.6.4 Perinidal Vessels and Flow Regulation in AVMs -- 5.6.5 Steal Phenomenon in Cerebral AVMs -- 5.7 Key Points -- References -- 6: AVM Presentation -- 6.1 Summary -- 6.2 Hemorrhagic Presentation and Aneurysmal SAH -- 6.3 Morbidity and Mortality of AVM-Related Intracranial Hemorrhage -- 6.4 Epilepsy Presentation -- 6.5 Focal Neurological Deficit -- 6.6 Key Points -- References -- 7: AVM Grading Schemes -- 7.1 Summary -- 7.2 Surgical AVM Grading -- 7.3 Radiosurgical AVM Grading -- 7.4 Endovascular Embolization AVM Gradings -- 7.5 Key Points -- References -- 8: Diagnostic Imaging -- 8.1 Summary -- 8.2 Introduction -- 8.3 Computed Tomography (CT) and CT Angiography (CTA) -- 8.4 Magnetic Resonance Imaging (MRI) and MR Angiography (MRA) -- 8.5 Digital Subtraction Angiography (DSA) -- 8.5.1 Selective Angiography -- 8.5.2 Superselective Angiography -- 8.5.3 Angiographic Findings -- 8.5.3.1 Arterial Feeders -- 8.5.3.2 The Nidus -- 8.5.3.3 Draining Veins -- 8.6 Key Points -- References -- 9: Treatment of AVM: Surgery -- 9.1 Summary -- 9.2 Introduction -- 9.3 Surgery -- 9.3.1 Planning -- 9.3.2 Positioning -- 9.3.3 Craniotomy -- 9.3.4 Dura Opening -- 9.3.5 Orientation -- 9.3.6 Sulcal Phase -- 9.3.7 Parenchymal Phase -- 9.3.8 Ependymal Phase -- 9.3.9 Final Steps -- 9.4 Combined Treatment -- 9.5 Endovascular Treatment -- 9.6 Radiosurgical Treatment -- 9.7 The Specific Situations -- 9.7.1 Associated Aneurysms -- 9.7.2 Concurrent Carotid Stenosis -- 9.7.3 Timing of Surgery -- 9.8 Specific Complications -- 9.8.1 Eloquent Areas -- 9.8.2 Ischemic Damage -- 9.8.3 Hemorrhagic Complications -- 9.9 The Worst Case -- 9.10 Conclusions -- 9.11 Key Points: Summary of Surgical Tricks and Tips -- References -- 10: Treatment of AVM: Endovascular Methods -- 10.1 Summary -- 10.2 Introduction. 10.3 Endovascular Conception of Brain AVM -- 10.3.1 The Lariboisière Endovascular Grading -- 10.3.2 Definition of the Various Types of AVM Embolizations -- 10.4 General Rules, Embolization Agents, and Microcatheters -- 10.4.1 Rules Common for All Interventions -- 10.4.2 Available Embolization Agents and Microcatheters: Advantages and Shortcomings -- 10.4.2.1 Cyanoacrylates -- 10.4.2.2 EVOH Copolymer-DMSO Solvent (Onyx) -- 10.4.2.3 Injectable Coils -- 10.4.2.4 Particles -- 10.4.2.5 Ethanol -- 10.4.3 Guiding Catheters and Microcatheters -- 10.4.3.1 Guiding Catheters -- 10.4.3.2 Microcatheters -- 10.5 Indications for Endovascular Treatment -- 10.5.1 Presurgical Embolization -- 10.5.2 Therapeutic Embolization -- 10.5.2.1 Therapeutic Embolization by a Transarterial Route -- 10.5.2.2 Therapeutic Embolization by a Transvenous Route -- 10.5.3 Symptomatic Embolization -- 10.5.4 Targeted Embolization -- 10.6 Complications of Endovascular Treatments of AVM -- 10.6.1 Ischemic Complications -- 10.6.2 Hemorrhagic Complications -- 10.6.3 Outcomes and Critical Assessment of the Endovascular Series -- 10.7 Indications for Treatment of AVM at the Lariboisière -- 10.8 Conclusion -- 10.9 Key Points -- References -- 11: Treatment of AVM: Stereotactic Radiosurgery -- 11.1 Summary -- 11.2 Introduction -- 11.3 The Decision to Offer Radiosurgery -- 11.3.1 The MDT -- 11.3.2 Patient Factors -- 11.3.3 AVM Factors -- 11.3.4 Referring Clinician and Institutional Factors -- 11.4 Angiography and Angio-Architecture -- 11.5 Pre-treatment Consultation and Assessment -- 11.6 Treatment -- 11.7 Response to Radiosurgery -- 11.7.1 Histopathological Response to Radiosurgery -- 11.7.2 Obliteration Rates -- 11.7.3 Grading System of Obliteration -- 11.7.4 Salvage Strategies and Choices in Case of Incomplete Obliteration -- 11.8 Complications. 11.8.1 Radiation Induced Complications and Management -- 11.8.2 Late Radiation Induced Complications and Malignancy -- 11.8.3 Rate, Morbidity and Mortality of Post-treatment Hemorrhage -- 11.9 Epilepsy and AVM Radiosurgery -- 11.10 Outcome Prediction After Radiosurgery -- 11.11 Controversies in Contemporary AVM Radiosurgery -- 11.11.1 Radiosurgery of Large AVMs -- 11.11.2 Radiosurgery and Embolization -- 11.11.3 Radiosurgery of Unruptured AVMs -- 11.12 Key Points -- References -- 12: Neurological Outcome and Efficacy of AVM Treatment -- 12.1 Summary -- 12.1.1 Literature Review -- 12.1.2 Military University Hospital Series -- 12.2 Introduction -- 12.3 Literature Series -- 12.3.1 Surgery -- 12.3.1.1 Efficacy of Surgical Treatment -- 12.3.1.2 Complication Rate of Surgical Series -- 12.3.2 Endovascular Embolization -- 12.3.2.1 Complication Rate of Endovascular Series -- 12.3.3 Stereotactic Radiosurgery -- 12.3.3.1 Complications of Radiosurgery -- 12.4 Combined Treatment -- 12.5 Military University Hospital Experience: Authors Series -- 12.5.1 Results -- 12.5.2 Probability of Bleeding in Longer Perspective -- 12.5.3 Indications for Surgical Treatment of AVM -- 12.5.4 Indications for Endovascular Treatment -- 12.5.5 Indications for Radiosurgical Treatment of AVMs -- 12.6 Key Points -- References -- 13: Neuropsychological Outcome of AVM Treatment -- 13.1 Summary -- 13.1.1 Military University Hospital: AVM Neuropsychology Study -- 13.2 Introduction -- 13.3 Neuropsychological Performance in AVM Patients -- 13.4 Military University Hospital: AVM Neuropsychology Study -- 13.4.1 Results -- 13.4.2 Treatment Decision for AVM: Implications -- 13.5 Key Points -- References -- 14: ARUBA Study Comments -- 14.1 Summary -- 14.2 ARUBA Study -- 14.3 ARUBA Study Comments -- 14.3.1 Site Selection. 14.3.2 Recruitment Bias and Outcome Measures -- 14.3.3 Length of Follow-Up -- 14.3.4 Low Proportion of Enrolled Patients -- 14.4 ARUBA Aftermath -- 14.5 Future Trials -- 14.6 Registries -- 14.7 Key Points -- References -- 15: Pediatric Arteriovenous Malformations -- 15.1 Summary -- 15.2 Introduction -- 15.3 Epidemiology -- 15.4 Pathophysiology -- 15.5 Clinical Presentation -- 15.6 Radiology -- 15.7 Management -- 15.7.1 Surgical Treatment -- 15.7.2 Embolization -- 15.7.3 Stereotactic Radiosurgery -- 15.8 Conclusions -- 15.9 Key Points -- References -- Index.

9783319639642


Cerebral arteriovenous malformations.


Electronic books.

RD592.5-596

610

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