Arteriovenous Malformation - Lecture 11 Flashcards

1
Q

AVM is a

A

birth defect

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2
Q

who is more common to get AVM

A

20-30 yr olds

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3
Q

size of AVM

A

can be tiny to the size of a whole hemisphere

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4
Q

what are AVMs

A

masses of abnormal blood vessels

appear as a tangle of arteries and veins

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5
Q

high pressure arteries

A

connect directly to low pressure arteries instead of through capillaries

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6
Q

what do they all share

A

characteristic of an AV connection w/o an intervening capillary network

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7
Q

what is abnormal

A

lack of O2 or glucose to brain tissue within the fistula

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8
Q

scarred in result to

A

tiny hemorrhages

may not have been noticed except for headache

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9
Q

what occasionally occurs

A

focal deficits

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10
Q

what do focal deficits result from

A

shunting away blood from healthy brain into fistula

cerebral steal syndrome

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11
Q

what is AVM the result of

A

abnormal fetal development

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12
Q

risk of bleed with AVM

A

1-4% per yr

preceded by intense headache and/or seizure

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13
Q

smaller AVMs are more likely

A

to bleed than larger d/t elevated arterial pressure in small vessels

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14
Q

how can hemorrhages be

A

parenchymal or SA

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15
Q

bleeds are often

A

less devastating

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16
Q

why’re bleeds less devestating

A

bleeds are primarily into the malformation

only incidentally into the adjacent brain

17
Q

long term prognosis

A

good

90% surviving the first bleed

18
Q

treatment options

A

radiation

embolization

surgery

19
Q

radiation

A

indicated for very small and deep AVMs

20
Q

embolization

A

indicated for larger AVMs

21
Q

what is used in embolization

A

angiogram

AVM is given agents which help decrease the blood supply to the malformation

22
Q

surgery

A

complete resection

disallowing them from recurring again

completely removed

23
Q

surgical interventions for hemorrhagic CVA

A

craniotomy and evacuation

craniectomy and evacuation if ICP is abnormally high

preoperative management of recurrent hemorrhage and vasospasm are important

24
Q

factors associated with recovery –> HCVAs

A

poorer survivability

better fxnal recovery

25
Q

factors associated with recovery –> ICVAs

A

good survivability

poorer fxnal recovery

26
Q

recovery can occur d/t

A

reduction of swelling or edema

existence of collateral blood flow

neuroplasticity

27
Q

lacunar CVA

A

relatively uncommon

28
Q

lacunar CVA has

A

characteristics of both ischemic and hemorrhagic CVA

29
Q

where do lacunar CVA occur

A

deep white matter of the brain where tiny arterioles branch off of larger vessels

vulnerable to hypertensive hemorrhage or the vessel may thicken or thrombose

30
Q

syndromes tend to be either (lacunar CVA)

A

pure motor

facial weakness

pure sensory

31
Q

pure motor

A

internal capsule - posterior limb

32
Q

facial weakness

A

internal capsule - anterior limb

33
Q

pure sensory

A

posterolateral thalamus

34
Q

prognosis of lacunar CVA

A

tends to be good