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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Transcranial Doppler diagnostic criteria in the evaluations of arteriovenous malformations

T Rundek1, V Demarin, M Lovrencić

  • 1Neurology Department, University Hospital, Sestre milosrdnice, Zagreb, Croatia.

Neurologia Croatica : Glasilo Udruzenja Neurologa Jugoslavije = Official Journal of Yugoslav Neurological Association
|January 1, 1991
PubMed

Insights

Transcranial Doppler (TCD) effectively assesses intracranial arteriovenous malformations (AVM) by revealing abnormal blood flow in feeding arteries. This technique provides crucial hemodynamic insights, particularly for large AVMs, aiding in diagnosis and management.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Medical Imaging

Background:

  • Intracranial arteriovenous malformations (AVMs) present complex hemodynamic challenges.
  • Conventional imaging like CT and angiography define AVMs but offer limited hemodynamic data.

Purpose of the Study:

  • To investigate the hemodynamic characteristics of intracranial AVMs using Transcranial Doppler (TCD).
  • To evaluate TCD parameters for assessing AVM severity and associated hemodynamic changes.

Main Methods:

  • Thirty-one patients with diagnosed intracranial AVMs were studied using TCD.
  • Key TCD parameters measured included mean cerebral blood flow velocities (MCBFV), pulsatility index (PI), and various ratios in feeding and non-feeding arteries.

Main Results:

  • TCD revealed normal findings in non-feeding arteries of all patients.
  • Significant hemodynamic differences (p < 0.01) were observed in feeding arteries compared to normal arteries.
  • MCBFV in the middle cerebral artery (MCA) was significantly higher in patients with large AVMs (>4 cm).

Conclusions:

  • TCD is valuable for assessing intracranial AVM hemodynamics, offering insights beyond conventional imaging.
  • TCD parameters, especially MCBFV, PI, and MCA/ICA ratio in feeding arteries, are sensitive to AVM presence and size.
  • Advanced TCD parameters like the (S-D)/S ratio and 3D hemodynamic mapping hold potential for improved AVM analysis.

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