AVM Flashcards

Question

SRS prons vs cons

Answer 1

Pron+ outpatient , non invasive , no recovery preriod , gradual reeducation , seizure control - latency period take 1-3 y to respond Risk of bleeding same during latency

Answer 2

Should done ✅ before 24-48 hr before resection Pros +facilitate surgery if size Cons- no permanent olitration , multiple procedures

Answer 3

W/ embolization 47% W/o 70%

Answer 4

associated aneurysms: on feeding vessels, draining veins, or intranidal 2. flow: high or low 3. age of patient 4. history of previous hemorrhage 5. size and compactness of nidus 6. availability of interventional neuroradiologist 7. general medical condition of the patient

Answer 5

Wide exposure Isolate and clip A then ▶️ vein Working sulci and fissure

Answer 6

NBPB normal pressure breakthrough ➡️ post op hemorrhage Strok ➡️ occlusive hypermia Rebleedin Seizure

Answer 7

If complete ✅ resection ⏩️ post op DSA or MRI then ⏩️ 1 &5 y CTA or MRA After SRS ☢️⏩️ a 6 m MRA, MRI oIF ❌🚫 CTA If obliterate bu SRS ☢️ post op DSA ( latency period )

Answer 8

parietal➡️ insula, frontal, and temporal lobe

Answer 9

Preiventricular

Answer 10

single draining vein single feeding artery Small nidus (<3 cm

Answer 11

Anatomical factor ; aneurysm , nidus( diffuse morphology ) , location ( deep preiventricular, intraventricualr, infratentorium) , impaired venous drainage ( deep venous drainage, venous stenosis, single draining vein, and venous reflux into a sinus or a deep vein), small size AVM Hemodynamic➡️ high feeding artery pressure Patient factor ➡️ increasing age, pediatric patients, pregnancy, HTN Others residual nidus S-M 4 -5

Answer 12

Arterial stenosis 2. Arterial angioectasia 3. Arterial border zone location of brain AVMs 4. Venous recruitment

Answer 13

Low CBF ➡️ ischmic insult brain Gliosis around nidus might cause seizure

Answer 14

Inclusion Criteria: Patient must have unruptured BAVM diagnosed by MRI/MRA, CTA and/or angiogram Patient must be 18 years of age or older Patient must have signed Informed Consent, Release of Medical Information, and Health Insurance Portability and Accountability Act (HIPAA/U.S. only) Forms Exclusion Criteria: Patient has BAVM presenting with evidence of recent or prior hemorrhage Patient has received prior BAVM therapy (endovascular, surgical, radiotherapy) Patient has BAVM deemed untreatable by local team, or has concomitant vascular or brain disease that interferes with/or contraindicates any interventional therapy type (stenosis/occlusion of neck artery, prior brain surgery/radiation for other reasons) Patient has baseline Rankin ≥2 Patient has concomitant disease reducing life expectancy to less than 10 years Patient has thrombocytopenia (< 100,000/μL), Patient has uncorrectable coagulopathy (INR>1.5) Patient is pregnant or lactating Patient has known allergy against iodine contrast agents Patient has multiple-foci BAVMs Patient has any form of arteriovenous or spinal fistulas Previous diagnosis of any of the following - Patient has a diagnosed Vein of Galen type malformation Patient has a diagnosed cavernous malformation Patient has a diagnosed dural arteriovenous fistula Patient has a diagnosed venous malformation Patient has a diagnosed neurocutaneous syndrome such as cerebro-retinal angiomatosis (von Hippel-Lindau), encephalo-trigeminal syndrome (Sturge-Weber), or Wyburn-Mason syndrome Patient has diagnosed BAVMs in context of moya-moya-type changes Patient has diagnosed hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber)

AVM Flashcards

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