Arteriovenous Malformations: Difference between revisions
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* The remainder w/ Sx related to the AVM (focal deficit, H/A, sz | * The remainder w/ Sx related to the AVM (focal deficit, H/A, sz | ||
** These Sx may be assoc. w/ hemorrhage, mechanical compression, irritation | ** 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) | * Medical attention in <span style="background-color:#fff2cc;">50% due to ruptured AVM</span> w/ hemorrhage (intraparenchymal MC, IVH, SDH, or SAH) | ||
Subgroups of Presentation - Ruptured, Unruptured ( ± w/ microhemorrhages) | Subgroups of Presentation - Ruptured, Unruptured ( ± w/ microhemorrhages) | ||
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== Hemorrhagic Presentation == | == Hemorrhagic Presentation == | ||
* Risk factors: Small size, deep location, exclusive deep venous drainage, and association with aneurysms. | * Risk factors: Small size, deep location, exclusive deep venous drainage, and association with aneurysms. | ||
* Pts who initially presents w/ hemorrhage, have a high risk of rehemorrhage (20%–40%). | * Pts who initially presents w/ hemorrhage, have a high risk of <span style="background-color:#fff2cc;">rehemorrhage (20%–40%)</span>. | ||
** The highest risk is w/i the first | ** The <span style="background-color:#fff2cc;">highest risk is w/i the first yr</span>. | ||
== Seizures as a Presentation == | == Seizures as a Presentation == | ||
* 15%–35% of initial presentation. | * <span style="background-color:#fff2cc;">15%–35%</span> of initial presentation. | ||
* Common in supratentorial AVMs. | * Common in supratentorial AVMs. | ||
* Related to hemorrhage, mass effect, or flow characteristics. | * Related to hemorrhage, mass effect, or flow characteristics. | ||
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== Other Presentations == | == Other Presentations == | ||
* Neurological deficits (<10%): Possibly due to steal phenomenon, microhemorrhages, mass effect. | * <span style="background-color:#fff2cc;">Neurological deficits (<10%)</span>: Possibly due to steal <u>phenomenon</u>, microhemorrhages, mass effect. | ||
* Headaches: May be due to meningeal artery involvement or venous outflow obstruction. | * Headaches: May be due to meningeal artery involvement or venous outflow obstruction. | ||
Revision as of 01:15, 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.
- Pts who initially presents w/ hemorrhage, have a high risk of rehemorrhage (20%–40%).
- The highest risk is w/i the first yr.
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 (<10%): Possibly due to steal phenomenon, microhemorrhages, mass effect.
- Headaches: May be due to meningeal artery involvement or venous outflow obstruction.