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Arteriovenous Malformations of the Pineal Region: Management and Controversies

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Pineal Region Lesions

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Abstract

Arteriovenous malformations (AVMs) are an allegedly rare congenital vascular pathology of unknown etiology that may arise in any region of the central nervous system. They are essentially an amalgamation of entangled and dilated abnormal vessels that shunt arterial blood directly into the venous system without an intervening capillary network. The most common presentation is hemorrhagic stroke, which represents the principal cause for non-traumatic intracranial hemorrhages in the young population. Epileptic seizures, chronic headache, and various progressive neurological disturbances may also transpire. The pineal region is a fairly uncommon site for these lesions, most such occurrences being restricted to case reports or a very limited number of patients in a case series. Moreover, the deep venous drainage and proximity to eloquent areas already elevate the difficulty of surgical resectability, regardless of AVM size. Therefore, the treatment of pineal AVMs may provide a greater challenge than other areas of the brain. In the following chapter, we present the epidemiology, clinical presentation, and pathological features of pineal region AVMs, followed by a detailed description on microsurgical removal. We also present a few cases operated in our department to serve as an example for vascular neurosurgeons.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania

    Ioan Alexandru Florian & Ioan Stefan Florian

  2. Physiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania

    Teodora Larisa Timiș

Authors
  1. Ioan Alexandru Florian
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  2. Teodora Larisa Timiș
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  3. Ioan Stefan Florian
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Editors and Affiliations

  1. Department of Neurosurgery, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania

    Ioan Stefan Florian

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Florian, I.A., Timiș, T.L., Florian, I.S. (2020). Arteriovenous Malformations of the Pineal Region: Management and Controversies. In: Florian, I.S. (eds) Pineal Region Lesions. Springer, Cham. https://doi.org/10.1007/978-3-030-50913-2_21

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