The Pathogenesis of Arteriovenous Malformations: Insights Provided by a Case of Multiple Arteriovenous Malformations Developing in Relation to a Developmental Venous Anomaly

The Pathogenesis of Arteriovenous Malformations: Insights Provided by a Case of Multiple... AbstractOBJECTIVE AND IMPORTANCE:Developmental venous anomalies (DVAs) are common anomalies of intracranialvenous drainage that may occur in conjunction with other cerebral vascular malformations. The present case raises important questions regarding the association between anomalous venous drainage patterns and the development of arteriovenous malformations (AVMs).CLINICAL PRESENTATION:We present the case of a 24-year-old man with small AVMs fed by the superior cerebellar artery that drained directly into a large DVA of the cerebellum.INTERVENTION:The patient was managed conservatively and returned 10 years later with recurrent symptoms. A repeat angiogram demonstrated spontaneous thrombosis of the previously documented AVMs; however, new AVMs at a different site that was also fed by the superior cerebellar artery and drained into the same DVA had appeared. The AVMs were completely embolized, and the DVA was left intact.CONCLUSION:Recently, increasing attention has focused on the possible importance of venous outflow disturbance and venous hypertension in the pathogenesis and pathophysiology of AVMs. The potentialmechanisms for this association and the implications of the present case are discussed, and the pertinent literature is reviewed. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

The Pathogenesis of Arteriovenous Malformations: Insights Provided by a Case of Multiple Arteriovenous Malformations Developing in Relation to a Developmental Venous Anomaly

The Pathogenesis of Arteriovenous Malformations: Insights Provided by a Case of Multiple Arteriovenous Malformations Developing in Relation to a Developmental Venous Anomaly

C O N C E P T The Pathogenesis of Arteriovenous Malformations: Insights Provided by a Case of Multiple Arteriovenous Malformations Developing in Relation to a Developmental Venous Anomaly Eric S. Nussbaum, M.D., Roberto C. Heros, M.D., Michael T. Madison, M.D., Deepak Awasthi, M.D., Charles L. Truwit, M.D. Departments of Neurological Surgery (ESN) and Radiology (MTM, CLT), University of Minnesota Hospital and C lin ic, Minneapolis, Minnesota; Department of Neurological Surgery (R C H ), University of Miami School of Medicine, Miami, Florida; and Department of Neurological Surgery (DA), Louisiana State University, New Orleans, Louisiana OBJECTIVE AND IM P O R T A N C E : Developmental venous anomalies (DVAs) are common anomalies of intracranial venous drainage that may o ccu r in conjunction with other cerebral vascular malformations. The present case raises important questions regarding the association between anomalous venous drainage patterns and the development of arteriovenous malformations (AVMs). CLINICAL PRESEN TATIO N : W e present the case of a 24-year-old man with small AVMs fed by the superior cerebellar artery that drained directly into a large D V A of the cerebellum. INTERVENTION: The patient was managed conservatively and returned 10 years later with recurrent symptoms. A repeat angiogram demonstrated spontaneous thrombosis of the previously documented AVMs; however, new AVMs at a different site that was also fed by the superior cerebellar artery and drained into the same D V A had appeared. The AVMs were com pletely embolized, and the D V A was left intact. CONCLUSION: Recently, increasing attention has focused on the possible importance of venous outflow distur­ bance and venous hypertension in the pathogenesis and pathophysiology of AVMs. The potential mechanisms for this association and the im plications of the present case are discussed, and the pertinent literature is reviewed. (Neurosurgery 4 3 :3 4 7 -3 5 2 , 1998) Key words:...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199808000-00103
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE AND IMPORTANCE:Developmental venous anomalies (DVAs) are common anomalies of intracranialvenous drainage that may occur in conjunction with other cerebral vascular malformations. The present case raises important questions regarding the association between anomalous venous drainage patterns and the development of arteriovenous malformations (AVMs).CLINICAL PRESENTATION:We present the case of a 24-year-old man with small AVMs fed by the superior cerebellar artery that drained directly into a large DVA of the cerebellum.INTERVENTION:The patient was managed conservatively and returned 10 years later with recurrent symptoms. A repeat angiogram demonstrated spontaneous thrombosis of the previously documented AVMs; however, new AVMs at a different site that was also fed by the superior cerebellar artery and drained into the same DVA had appeared. The AVMs were completely embolized, and the DVA was left intact.CONCLUSION:Recently, increasing attention has focused on the possible importance of venous outflow disturbance and venous hypertension in the pathogenesis and pathophysiology of AVMs. The potentialmechanisms for this association and the implications of the present case are discussed, and the pertinent literature is reviewed.

Journal

NeurosurgeryOxford University Press

Published: Aug 1, 1998

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