Arteriovenous Malformations: Difference between revisions
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= Definition = | |||
* Fistulous connections b/w cerebral arteries & veins w/o a nml capillary bed. | |||
= Clinical Presentation = | |||
* Up to 40% present w/ unrelated Sx. | |||
* The remainder w/ Sx related to the AVM (focal deficit, H/A, sz | |||
** These Sx may be assoc. w/ hemorrhage, mechanical compression, irritation | |||
* Medical attention in 50% due to ruptured AVM w/ hemorrhage (intraparenchymal MC, IVH, SDH, or SAH) | |||
Subgroups of Presentation - Ruptured, Unruptured ( ± w/ microhemorrhages) | |||
== Hemorrhagic Presentation == | |||
* Risk factors: Small size, deep location, exclusive deep venous drainage, and association with aneurysms. | |||
* R2eD AVM score as a predictive tool. | |||
* Significant morbidity and mortality associated with initial hemorrhage. | |||
== Seizures as a Presentation == | |||
* 15%–35% of initial presentation. | |||
* Common in supratentorial AVMs. | |||
* Related to hemorrhage, mass effect, or flow characteristics. | |||
* Risk factors: Superficial location, large nidus, cortical location. | |||
== Other Presentations == | |||
* Neurological deficits: Possibly due to steal phenomenon, microhemorrhages, mass effect. | |||
* Headaches: May be due to meningeal artery involvement or venous outflow obstruction. | |||
= Old presentation = | = Old presentation = | ||
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[[Category:Vascular Pathology]] | [[Category:Vascular Pathology]] | ||
[[Category:Cerebral Vascular Malformations]] | [[Category:Cerebral Vascular Malformations]] | ||
Revision as of 01:01, 3 March 2024
Definition
- Fistulous connections b/w cerebral arteries & veins w/o a nml capillary bed.
Clinical Presentation
- Up to 40% present w/ unrelated Sx.
- The remainder w/ Sx related to the AVM (focal deficit, H/A, sz
- These Sx may be assoc. w/ hemorrhage, mechanical compression, irritation
- Medical attention in 50% due to ruptured AVM w/ hemorrhage (intraparenchymal MC, IVH, SDH, or SAH)
Subgroups of Presentation - Ruptured, Unruptured ( ± w/ microhemorrhages)
Hemorrhagic Presentation
- Risk factors: Small size, deep location, exclusive deep venous drainage, and association with aneurysms.
- R2eD AVM score as a predictive tool.
- Significant morbidity and mortality associated with initial hemorrhage.
Seizures as a Presentation
- 15%–35% of initial presentation.
- Common in supratentorial AVMs.
- Related to hemorrhage, mass effect, or flow characteristics.
- Risk factors: Superficial location, large nidus, cortical location.
Other Presentations
- Neurological deficits: Possibly due to steal phenomenon, microhemorrhages, mass effect.
- Headaches: May be due to meningeal artery involvement or venous outflow obstruction.