Hemodynamics Associated With Intracerebral Arteriovenous Malformations: The Effects of Treatment Modalities

Document Type

Article

Abstract

The understanding of the physiology of cerebral arteriovenous malformations (AVMs) continues to expand. Knowledge of the hemodynamics of blood flow associated with AVMs is also progressing as imaging and treatment modalities advance. The authors present a comprehensive literature review that reveals the physical hemodynamics of AVMs, and the effect that various treatment modalities have on AVM hemodynamics and the surrounding cortex and vasculature. The authors discuss feeding arteries, flow through the nidus, venous outflow, and the relative effects of radiosurgical monotherapy, endovascular embolization alone, and combined microsurgical treatments. The hemodynamics associated with intracranial AVMs is complex and likely changes over time with changes in the physical morphology and angioarchitecture of the lesions. Hemodynamic change may be even more of a factor as it pertains to the vast array of single and multimodal treatment options available. An understanding of AVM hemodynamics associated with differing treatment modalities can affect treatment strategies and should be considered for optimal clinical outcomes.

Medical Subject Headings

Combined Modality Therapy (methods); Embolization, Therapeutic (methods); Endovascular Procedures (methods); Female; Hemodynamics (physiology); Humans; Intracranial Arteriovenous Malformations (physiopathology, therapy); Male; Neurosurgical Procedures (methods)

Publication Date

10-1-2018

Publication Title

Neurosurgery

E-ISSN

1524-4040

Volume

83

Issue

4

First Page

611

Last Page

621

PubMed ID

29267943

Digital Object Identifier (DOI)

10.1093/neuros/nyx560

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