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Arteriovenous Malformations of the Anterior Fossa

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Cerebrovascular and Endovascular Neurosurgery

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Abstract

The modern management of the cerebral arteriovenous malformations (AVMs) is based on multidisciplinary and multimodality treatment approach including endovascular embolization, microsurgery, and stereotactic radiosurgery. Complications are well established in the microsurgical treatment of the cerebral arteriovenous malformations (AVMs). Higher complication rate can potentially reflect in poor patient outcome. Thorough knowledge of the natural history, detailed understanding of the angioarchitectural features, and awareness of the risk factors for hemorrhage are essential in the decision analysis for treatment of the cerebral AVMs. Appropriate patient selection, treatment strategy, choice of equipment, and being aware of ones’ own limitations are vital in minimizing the complications. Complication awareness and high index of suspicion helps in early detection of complications. Having a well-thought-out plan for dealing with individual complications may make the difference between an uneventful outcome and death. In this chapter, we discuss the potential complications in the endovascular and microsurgical treatment of the cerebral AVMs and provide suggestions for avoidance and management of the complications based on the literature review and authors’ institutional experience.

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References

  1. Perret G, Nishioka H. Report on the cooperative study of intracranial aneurysms and subarachnoid hemorrhage. Section VI. Arteriovenous malformations. An analysis of 545 cases of cranio-cerebral arteriovenous malformations and fistulae reported to the cooperative study. J Neurosurg. 1966;25(4):467–90. https://doi.org/10.3171/jns.1966.25.4.0467.

    Article  PubMed  CAS  Google Scholar 

  2. Schlachter LB, Fleischer AS, Faria MA, Tindall GT. Multifocal intracranial arteriovenous malformations. Neurosurgery. 1980;7(5):440–4.

    Article  CAS  PubMed  Google Scholar 

  3. Yasargil M. Microneurosurgery IIIB: AVM of the brain. New York: Thieme; 1998.

    Google Scholar 

  4. Hofmeister C, Stapf C, Hartmann A, et al. Demographic, morphological, and clinical characteristics of 1289 patients with brain arteriovenous malformation. Stroke. 2000;31(6):1307–10.

    Article  CAS  PubMed  Google Scholar 

  5. Wilkins RH. Natural history of intracranial vascular malformations: a review. Neurosurgery. 1985;16(3):421–30.

    Article  CAS  PubMed  Google Scholar 

  6. Ondra SL, Troupp H, George ED, Schwab K. The natural history of symptomatic arteriovenous malformations of the brain: a 24-year follow-up assessment. J Neurosurg. 1990;73(3):387–91. https://doi.org/10.3171/jns.1990.73.3.0387.

    Article  PubMed  CAS  Google Scholar 

  7. Willinsky RA, Lasjaunias P, Terbrugge K, Burrows P. Multiple cerebral arteriovenous malformations (AVMs). Review of our experience from 203 patients with cerebral vascular lesions. Neuroradiology. 1990;32(3):207–10.

    Article  CAS  PubMed  Google Scholar 

  8. Hernesniemi JA, Dashti R, Juvela S, Väärt K, Niemelä M, Laakso A. Natural history of brain arteriovenous malformations: a long-term follow-up study of risk of hemorrhage in 238 patients. Neurosurgery. 2008;63(5):823–829.; Discussion 829–831. https://doi.org/10.1227/01.NEU.0000330401.82582.5E.

    Article  PubMed  Google Scholar 

  9. da Costa L, Thines L, Dehdashti AR, et al. Management and clinical outcome of posterior fossa arteriovenous malformations: report on a single-centre 15-year experience. J Neurol Neurosurg Psychiatry. 2009;80(4):376–9. https://doi.org/10.1136/jnnp.2008.152710.

    Article  PubMed  Google Scholar 

  10. Gross BA, Du R. Natural history of cerebral arteriovenous malformations: a meta-analysis. J Neurosurg. 2013;118(2):437–43. https://doi.org/10.3171/2012.10.JNS121280.

    Article  PubMed  Google Scholar 

  11. Graf CJ, Perret GE, Torner JC. Bleeding from cerebral arteriovenous malformations as part of their natural history. J Neurosurg. 1983;58(3):331–7. https://doi.org/10.3171/jns.1983.58.3.0331.

    Article  PubMed  CAS  Google Scholar 

  12. Brown RD, Wiebers DO, Forbes G, et al. The natural history of unruptured intracranial arteriovenous malformations. J Neurosurg. 1988;68(3):352–7. https://doi.org/10.3171/jns.1988.68.3.0352.

    Article  PubMed  Google Scholar 

  13. Crawford PM, West CR, Chadwick DW, Shaw MD. Arteriovenous malformations of the brain: natural history in unoperated patients. J Neurol Neurosurg Psychiatry. 1986;49(1):1–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Mohr JP, Parides MK, Stapf C, et al. Medical management with or without interventional therapy for unruptured brain arteriovenous malformations (ARUBA): a multicentre, non-blinded, randomised trial. Lancet. 2014;383(9917):614–21. https://doi.org/10.1016/S0140-6736(13)62302-8.

    Article  PubMed  CAS  Google Scholar 

  15. Kondziolka D, McLaughlin MR, Kestle JR. Simple risk predictions for arteriovenous malformation hemorrhage. Neurosurgery. 1995;37(5):851–5.

    Article  CAS  PubMed  Google Scholar 

  16. Brown RD. Simple risk predictions for arteriovenous malformation hemorrhage. Neurosurgery. 2000;46(4):1024.

    Article  PubMed  Google Scholar 

  17. Jafar JJ, Rezai AR. Acute surgical management of intracranial arteriovenous malformations. Neurosurgery. 1994;34(1):8–12. Discussion 12–13.

    PubMed  CAS  Google Scholar 

  18. Heros RC, Korosue K, Diebold PM. Surgical excision of cerebral arteriovenous malformations: late results. Neurosurgery. 1990;26(4):570–7. Discussion 577–8.

    Article  CAS  PubMed  Google Scholar 

  19. Beecher JS, Vance A, Lyon KA, et al. 359 Delayed treatment of ruptured arteriovenous malformations: is it ok to wait? Neurosurgery. 2016;63(Suppl 1):206. https://doi.org/10.1227/01.neu.0000489848.55193.2e.

    Article  Google Scholar 

  20. Goyal N, Hoit D, Elijovich L. Spontaneous thrombosis of a ruptured brain arteriovenous malformation: the argument for early conservative management. Interv Neurol. 2015;3(3–4):122–8. https://doi.org/10.1159/000381035.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Wallace RC, Bourekas EC. Brain arteriovenous malformations. Neuroimaging Clin N Am. 1998;8(2):383–99.

    PubMed  CAS  Google Scholar 

  22. Lasjaunias PL, Landrieu P, Rodesch G, et al. Cerebral proliferative angiopathy clinical and angiographic description of an entity different from cerebral AVMs. Stroke. 2008;39(3):878–85. https://doi.org/10.1161/STROKEAHA.107.493080.

    Article  PubMed  Google Scholar 

  23. Heros RC. Brain resection for exposure of deep extracerebral and paraventricular lesions. Surg Neurol. 1990;34(3):188–95.

    Article  CAS  PubMed  Google Scholar 

  24. Lavine S, Giannotta S. Surgical complications. In: Stieg P, Batjer HH, Samson DS, editors. Intracranial arteriovenous malformations. New York: Informa Healthcare; 2007.

    Google Scholar 

  25. Morgan MK, Rochford AM, Tsahtsarlis A, Little N, Faulder KC. Surgical risks associated with the management of grade I and II brain arteriovenous malformations. Neurosurgery. 2004;54(4):832–7. Discussion 837–839.

    Article  PubMed  Google Scholar 

  26. Martin N, Doberstein C, Bentson J, Vinuela F, Dion J, Becker D. Intraoperative angiography in cerebrovascular surgery. Clin Neurosurg. 1991;37:312–31.

    PubMed  CAS  Google Scholar 

  27. Spetzler RF, Wilson CB, Weinstein P, Mehdorn M, Townsend J, Telles D. Normal perfusion pressure breakthrough theory. Clin Neurosurg. 1978;25:651–72.

    Article  CAS  PubMed  Google Scholar 

  28. Day AL, Friedman WA, Sypert GW, Mickle JP. Successful treatment of the normal perfusion pressure breakthrough syndrome. Neurosurgery. 1982;11(5):625–30.

    Article  CAS  PubMed  Google Scholar 

  29. Wilson CB, Hieshima G. Occlusive hyperemia: a new way to think about an old problem. J Neurosurg. 1993;78(2):165–6. https://doi.org/10.3171/jns.1993.78.2.0165.

    Article  PubMed  CAS  Google Scholar 

  30. Heros RC, Korosue K. Deep parenchymous lesions. In: Apuzzo M, editor. Brain surgery. Complication avoidance and management. New York: Churchill Livingstone; 1990.

    Google Scholar 

  31. Drake CG. Cerebral arteriovenous malformations: considerations for and experience with surgical treatment in 166 cases. Clin Neurosurg. 1979;26:145–208.

    Article  CAS  PubMed  Google Scholar 

  32. al-Rodhan NR, Sundt TM, Piepgras DG, Nichols DA, Rüfenacht D, Stevens LN. Occlusive hyperemia: a theory for the hemodynamic complications following resection of intracerebral arteriovenous malformations. J Neurosurg. 1993;78(2):167–75. https://doi.org/10.3171/jns.1993.78.2.0167.

    Article  PubMed  CAS  Google Scholar 

  33. Weinand M. In: Carter L, Spetzler RF, Hamilton MG, editors. Arteriovenous malformations and epilepsy. New York: McGraw-Hill; 1995.

    Google Scholar 

  34. Luessenhop AJ, Presper JH. Surgical embolization of cerebral arteriovenous malformations through internal carotid and vertebral arteries. Long-term results. J Neurosurg. 1975;42(4):443–51. https://doi.org/10.3171/jns.1975.42.4.0443.

    Article  PubMed  CAS  Google Scholar 

  35. Nornes H, Lundar T, Wikeby P. Cerebral arteriovenous malformations; results of microsurgical management. Acta Neurochir. 1979;50(3–4):243–57.

    Article  CAS  PubMed  Google Scholar 

  36. Adelt D, Zeumer H, Wolters J. Surgical treatment of cerebral arteriovenous malformations. Follow-up study of 43 cases. Acta Neurochir. 1985;76(1–2):45–9.

    Article  CAS  PubMed  Google Scholar 

  37. Mckissock W, Paterson JH. A clinical survey of intracranial angiomas with special reference to their mode of progression and surgical treatment: a report of 110 cases. Brain J Neurol. 1956;79(2):233–66.

    Article  CAS  Google Scholar 

  38. Forster DM, Steiner L, Håkanson S. Arteriovenous malformations of the brain. A long-term clinical study. J Neurosurg. 1972;37(5):562–70. https://doi.org/10.3171/jns.1972.37.5.0562.

    Article  PubMed  CAS  Google Scholar 

  39. Magro E, Gentric J-C, Darsaut TE, et al. Treatment of brain AVMS (TOBAS): a randomized controlled trial and registry. Neurochirurgie. 2016. https://doi.org/10.1016/j.neuchi.2015.12.008.

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Authors and Affiliations

  1. Division of Interventional Neuroradiology, Department of Neurological Surgery, Weill Cornell Medical Center/New York Presbyterian Hospital, New York, NY, 10065, USA

    Srikanth R. Boddu M.Sc., M.R.C.S., F.R.C.R., M.D., Thomas W. Link M.D., M.S., Jared Knopman M.D. & Philip E. Stieg M.D., Ph.D.

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  1. Srikanth R. Boddu M.Sc., M.R.C.S., F.R.C.R., M.D.
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  2. Thomas W. Link M.D., M.S.
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  3. Jared Knopman M.D.
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  4. Philip E. Stieg M.D., Ph.D.
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Corresponding author

Correspondence to Srikanth R. Boddu M.Sc., M.R.C.S., F.R.C.R., M.D. .

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Editors and Affiliations

  1. Department of Neurosurgery, Westchester Medical Center/NY Medical College, Valhalla, New York, USA

    Chirag D. Gandhi

  2. Department of Neurological Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA

    Charles J. Prestigiacomo

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Boddu, S.R., Link, T.W., Knopman, J., Stieg, P.E. (2018). Arteriovenous Malformations of the Anterior Fossa. In: Gandhi, C., Prestigiacomo, C. (eds) Cerebrovascular and Endovascular Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-65206-1_15

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  • DOI: https://doi.org/10.1007/978-3-319-65206-1_15

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  • Online ISBN: 978-3-319-65206-1

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