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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Brain edema associated with unruptured brain arteriovenous malformations
Bum-soo Kim1, Dipanka Sarma, Seon-Kyu Lee
1Department of Radiology, Kangnam St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
Neuroradiology
|February 17, 2009
Summary
Brain edema is rare in unruptured brain arteriovenous malformations (AVMs), affecting 3.9% of patients. Venous outflow abnormalities are common and linked to edema, potentially increasing hemorrhage risk.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Brain edema is an uncommon complication of unruptured brain arteriovenous malformations (AVMs).
- Understanding the frequency, clinical presentation, and imaging findings of edema in AVMs is crucial for patient management.
Purpose of the Study:
- To determine the frequency and clinical presentation of brain edema in unruptured brain AVMs.
- To analyze imaging findings, particularly venous drainage abnormalities, associated with brain edema.
- To evaluate the implications of these findings on the natural history and management of unruptured brain AVMs.
Main Methods:
- Prospective data collection from a brain AVM database.
- Recording of neurological findings, AVM characteristics, and presence of brain edema.
- Review of treatment details and follow-up for patients with brain edema, with comparison to those without edema.
Main Results:
- Brain edema was identified in 3.9% (13/329) of unruptured brain AVMs.
- Patients with edema showed higher rates of neurological deficit, venous thrombosis, venous ectasia, stenosis, and contrast stagnation.
- Eight patients received treatment (embolization, surgery, radiosurgery), with some experiencing symptom improvement, but three later developed intracranial hemorrhage.
Conclusions:
- Brain edema is a rare but significant finding in unruptured brain AVMs, often associated with venous outflow abnormalities.
- The presence of edema may indicate progressive nonhemorrhagic symptoms and a potential increased risk of hemorrhage.
- While palliative embolization can manage nonhemorrhagic symptoms, its effect on hemorrhagic risk remains uncertain.
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