[Neuroradiologic exploration of cerebral arteriovenous malformations]

MR and superselective neuroangiographic investigation of 223 patients with cerebral arteriovenous malformations (AVMs) were retrospectively analyzed with regard to topography, morphology, vascular architecture and signs of increased bleeding risk. MR proved highly efficient in defining the topography of the lesion and highly sensitive in detecting AVM-induced parenchymal changes. Superselective neuroangiography enables complete endovascular mapping of the AVM and provides relevant information on its intrinsic vascular composition. In addition, this method gives new insights into the venous drainage patterns and the unexpectedly high incidence of associated venous changes. MR-neuroangiographic correlation in each individual case forms the basis for any therapeutic decision and treatment planning. In concordance with previous statements in the literature this study disclosed that the presence of stenotic draining veins or related aneurysms on feeding arteries represents an increased risk for AVM rupture.