• Curr Opin Anaesthesiol · Oct 2005

    Management of brain arteriovenous malformations.

    • Chanhung Z Lee and William L Young.
    • Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco General Hospital, California 94110, USA. clee4@anesthesia.ucsf.edu
    • Curr Opin Anaesthesiol. 2005 Oct 1; 18 (5): 484-9.

    Purpose Of ReviewThis review highlights recent data regarding factors associated with brain arteriovenous malformation hemorrhage and different treatment options.Recent FindingsMore risk factors were identified in association with intracranial hemorrhage, including age at initial diagnosis of arteriovenous malformation, co-existing extranidal aneurysms and genetic factors. Patients with unruptured arteriovenous malformations were found to be more susceptible to worsening in neurological function after microsurgery compared with those presenting with hemorrhagic arteriovenous malformation. Radiosurgery has achieved satisfactory obliteration of deep arteriovenous malformations, but with increased actuarial hemorrhage rates from the first to the fifth year. Although the Intraoperative Hypothermia for Aneurysm Surgery Trial failed to show a significant neurological improvement, the superior efficiency of endovascular cooling has offered optimism in cerebral protection during neurovascular surgeries by shortening the time to achieve hypothermia and rewarming. A multi-center trial (ARUBA) has been proposed to test the hypothesis that, for unruptured brain arteriovenous malformations, there is no difference between interventional and conservative management. Recent studies have also shown the promise of using tetracyclines to decrease the rate of spontaneous arteriovenous malformation rupture.SummaryThe recent identification of clinical and genetic factors associated with brain arteriovenous malformation hemorrhage, as well as studies on treatment outcomes, will help risk stratification in management choices. Future studies are needed to identify arteriovenous malformation patients at the greatest risk of spontaneous hemorrhage and to develop specific medical therapies.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…