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Arteriovenous Malformations of the Brain: II: Current Concepts and Treatment

Arteriovenous Malformations of the Brain: II: Current Concepts and Treatment Abstract • In this second of a two-part article, the treatment of arteriovenous malformations (AVMs) of the brain is discussed. The natural course of these lesions, which is treacherous, must be balanced against the risk-effectiveness of various therapies. Radiotherapy rarely abolishes these lesions and subjects the patient to the risk of radionecrosis and rebleed from the AVM. Embolization, which involves the placement of small spheres into the lesion under radiographic control, is a moderately safe procedure that can reduce the size of, but rarely eliminates, these malformations. Embolization, however, has been used effectively in preparing the lesion for excision. The techniques of contemporary surgery and the results of treatment of a large number of AVMs are discussed. References 1. French LA, Chou SN, Story JL: Cerebrovascular malformations , in Shillito J Jr (ed): Clinical Neurosurgery . Baltimore, Williams & Wilkins Co, 1964, vol 11, pp 171-182. 2. MacKenzie I: The clinical presentation of the cerebral angioma: A review of 50 cases . Brain 76:184-214, 1953.Crossref 3. Morello G, Broghi GP: Cerebral angiomas: A report of 154 personal cases and a comparison between the results of surgical excision and conservative management . Acta Neurochir 28:135-155, 1973.Crossref 4. Paterson JH, McKissock W: A clinical survey of intracranial angiomas with special reference to their mode of progression and surgical treatment: A report of 110 cases . Brain 79:233-266, 1965.Crossref 5. Pia HW, Gleave JRW, Grote E, et al (eds): Cerebral Angiomas: Advances in Diagnosis and Therapy . New York, Springer Publishing Co Inc, 1975. 6. Pool JL, Potts DG: Aneurysms and Arteriovenous Anomalies of the Brain: Diagnosis and Treatment . New York, Harper & Row, 1965, p 463. 7. Porter AJ, Bull J: Some aspects of the natural history of cerebral arteriovenous malformation . Br J Radiol 42:667-675, 1969.Crossref 8. Sano K: Intracranial arteriovenous malformation with special reference to its treatment . Neurol Med Chir 6:28-34, 1964.Crossref 9. Troupp H, Marttila I, Halonen V: Arteriovenous malformations of the brain: Prognosis without operation . Acta Neurochir 22:125-128, 1970.Crossref 10. Kelly DL, Alexander E Jr, Davis CH Jr, et al: Intracranial arteriovenous malformations: Clinical review and evaluation of brain scans . J Neurosurg 31:422-428, 1969.Crossref 11. Svien HJ, McRae JA: Arteriovenous anomalies of the brain: Fate of patients not having definitive surgery . J Neurosurg 23:23-28, 1965.Crossref 12. Troupp H: Arteriovenous malformations of the brain: What are the indications for operation? in Morley TP (ed): Current Controversies in Neurosurgery . Philadelphia, WB Saunders Co, 1976, pp 210-216. 13. Luessenhop AJ, Presper JH: Surgical embolization of cerebral arteriovenous malformations through internal carotid and vertebral arteries . J Neurosurg 42:443-451, 1975.Crossref 14. Kjellberg RN: Proton beam therapy of AVM. Presented at the Harvard Neurosurgery Postgraduate Course, Nov 16, 1978. 15. Sano K, Jimbo M, Saito I, et al: Artificial embolization with liquid plastic . Neurol Med Chir 8:198-201, 1966.Crossref 16. Wolpert SM, Stein BM: Catheter embolization of intracranial arteriovenous malformations as an aid to surgical excision . Neuroradiology 10:73-85, 1975. 17. Boulos R, Kricheff I, Chase NE: Value of cerebral angiography in the embolization treatment of cerebral arteriovenous malformations . Radiology 97:65-70, 1970. 18. Djindjian R, Houdart R: Arteriographie super-selective de la carotide interne et embolisation . Rev Neurol 131:829-846, 1975. 19. Fleischer AS, Kricheff I, Ransohoff J: Postmortem findings following the embolization of an arteriovenous malformation . J Neurosurg 37:606-609, 1972.Crossref 20. Kricheff I, Madayag M, Braunstein P: Transfemoral catheter embolization of cerebral and posterior fossa arteriovenous malformations . Radiology 103:107-111, 1972.Crossref 21. Luessenhop AJ, Kachmann R, Shevlin W, et al: Clinical evaluation of artificial embolization in the management of large cerebral arteriovenous malformations . J Neurosurg 23:400-417, 1965.Crossref 22. Wolpert SM, Stein BM: Factors governing the course of emboli in the therapeutic embolization of cerebral arteriovenous malformations . Radiology 131:125-131, 1979.Crossref 23. Kerber C: Intracranial cyanoacrylate: A new catheter therapy for arteriovenous malformation . Invest Radiol 10:536-538, 1975.Crossref 24. Kendall BE, Claveria LE: The use of computed axial tomography (CAT) for the diagnosis and management of intracranial angiomas . Neuroradiology 12:141-160, 1976.Crossref 25. Juhász J: Surgical treatment of arteriovenous angiomas localized in the corpus callosum, basal ganglia and near the brain stem . Acta Neurochir (Wein) 40:83-101, 1978.Crossref 26. Pool JL: Excision of cerebral arteriovenous malformations . J Neurosurg 29:312-321, 1968.Crossref 27. Spetzler RF, Wilson CB, Weinstein P, Mehdorn M, Townsend J, Telles D: Normal perfusion pressure breakthrough theory , in Keever EB (ed): Clinical Neurosurgery . Baltimore, Maryland, Williams & Wilkins, 1977, vol 25, pp 651-672. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Arteriovenous Malformations of the Brain: II: Current Concepts and Treatment

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References (29)

Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1980.00500510027003
Publisher site
See Article on Publisher Site

Abstract

Abstract • In this second of a two-part article, the treatment of arteriovenous malformations (AVMs) of the brain is discussed. The natural course of these lesions, which is treacherous, must be balanced against the risk-effectiveness of various therapies. Radiotherapy rarely abolishes these lesions and subjects the patient to the risk of radionecrosis and rebleed from the AVM. Embolization, which involves the placement of small spheres into the lesion under radiographic control, is a moderately safe procedure that can reduce the size of, but rarely eliminates, these malformations. Embolization, however, has been used effectively in preparing the lesion for excision. The techniques of contemporary surgery and the results of treatment of a large number of AVMs are discussed. References 1. French LA, Chou SN, Story JL: Cerebrovascular malformations , in Shillito J Jr (ed): Clinical Neurosurgery . Baltimore, Williams & Wilkins Co, 1964, vol 11, pp 171-182. 2. MacKenzie I: The clinical presentation of the cerebral angioma: A review of 50 cases . Brain 76:184-214, 1953.Crossref 3. Morello G, Broghi GP: Cerebral angiomas: A report of 154 personal cases and a comparison between the results of surgical excision and conservative management . Acta Neurochir 28:135-155, 1973.Crossref 4. Paterson JH, McKissock W: A clinical survey of intracranial angiomas with special reference to their mode of progression and surgical treatment: A report of 110 cases . Brain 79:233-266, 1965.Crossref 5. Pia HW, Gleave JRW, Grote E, et al (eds): Cerebral Angiomas: Advances in Diagnosis and Therapy . New York, Springer Publishing Co Inc, 1975. 6. Pool JL, Potts DG: Aneurysms and Arteriovenous Anomalies of the Brain: Diagnosis and Treatment . New York, Harper & Row, 1965, p 463. 7. Porter AJ, Bull J: Some aspects of the natural history of cerebral arteriovenous malformation . Br J Radiol 42:667-675, 1969.Crossref 8. Sano K: Intracranial arteriovenous malformation with special reference to its treatment . Neurol Med Chir 6:28-34, 1964.Crossref 9. Troupp H, Marttila I, Halonen V: Arteriovenous malformations of the brain: Prognosis without operation . Acta Neurochir 22:125-128, 1970.Crossref 10. Kelly DL, Alexander E Jr, Davis CH Jr, et al: Intracranial arteriovenous malformations: Clinical review and evaluation of brain scans . J Neurosurg 31:422-428, 1969.Crossref 11. Svien HJ, McRae JA: Arteriovenous anomalies of the brain: Fate of patients not having definitive surgery . J Neurosurg 23:23-28, 1965.Crossref 12. Troupp H: Arteriovenous malformations of the brain: What are the indications for operation? in Morley TP (ed): Current Controversies in Neurosurgery . Philadelphia, WB Saunders Co, 1976, pp 210-216. 13. Luessenhop AJ, Presper JH: Surgical embolization of cerebral arteriovenous malformations through internal carotid and vertebral arteries . J Neurosurg 42:443-451, 1975.Crossref 14. Kjellberg RN: Proton beam therapy of AVM. Presented at the Harvard Neurosurgery Postgraduate Course, Nov 16, 1978. 15. Sano K, Jimbo M, Saito I, et al: Artificial embolization with liquid plastic . Neurol Med Chir 8:198-201, 1966.Crossref 16. Wolpert SM, Stein BM: Catheter embolization of intracranial arteriovenous malformations as an aid to surgical excision . Neuroradiology 10:73-85, 1975. 17. Boulos R, Kricheff I, Chase NE: Value of cerebral angiography in the embolization treatment of cerebral arteriovenous malformations . Radiology 97:65-70, 1970. 18. Djindjian R, Houdart R: Arteriographie super-selective de la carotide interne et embolisation . Rev Neurol 131:829-846, 1975. 19. Fleischer AS, Kricheff I, Ransohoff J: Postmortem findings following the embolization of an arteriovenous malformation . J Neurosurg 37:606-609, 1972.Crossref 20. Kricheff I, Madayag M, Braunstein P: Transfemoral catheter embolization of cerebral and posterior fossa arteriovenous malformations . Radiology 103:107-111, 1972.Crossref 21. Luessenhop AJ, Kachmann R, Shevlin W, et al: Clinical evaluation of artificial embolization in the management of large cerebral arteriovenous malformations . J Neurosurg 23:400-417, 1965.Crossref 22. Wolpert SM, Stein BM: Factors governing the course of emboli in the therapeutic embolization of cerebral arteriovenous malformations . Radiology 131:125-131, 1979.Crossref 23. Kerber C: Intracranial cyanoacrylate: A new catheter therapy for arteriovenous malformation . Invest Radiol 10:536-538, 1975.Crossref 24. Kendall BE, Claveria LE: The use of computed axial tomography (CAT) for the diagnosis and management of intracranial angiomas . Neuroradiology 12:141-160, 1976.Crossref 25. Juhász J: Surgical treatment of arteriovenous angiomas localized in the corpus callosum, basal ganglia and near the brain stem . Acta Neurochir (Wein) 40:83-101, 1978.Crossref 26. Pool JL: Excision of cerebral arteriovenous malformations . J Neurosurg 29:312-321, 1968.Crossref 27. Spetzler RF, Wilson CB, Weinstein P, Mehdorn M, Townsend J, Telles D: Normal perfusion pressure breakthrough theory , in Keever EB (ed): Clinical Neurosurgery . Baltimore, Maryland, Williams & Wilkins, 1977, vol 25, pp 651-672.

Journal

Archives of NeurologyAmerican Medical Association

Published: Feb 1, 1980

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