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[Intracranial vascular malformations].

D F Vollherbst1, M Bendszus1, M A Möhlenbruch2

  • 1Abteilung für Neuroradiologie, Neurologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.

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|September 15, 2018
PubMed
Summary
This summary is machine-generated.

Intracranial vascular malformations vary in severity. Arteriovenous malformations and dural arteriovenous fistulas pose risks of hemorrhage and require treatment, while cavernous malformations, developmental venous anomalies, and capillary telangiectasias are often asymptomatic.

Keywords:
Arteriovenous fistulaCentral nervous system vascular malformationsIntracranial arteriovenous malformationsTelangiectasia, capillaryVascular diseases

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Area of Science:

  • Neurology
  • Neurosurgery
  • Vascular Medicine

Background:

  • Intracranial vascular malformations present a spectrum from asymptomatic findings to life-threatening conditions.
  • Cerebral vascular malformations include those with (arteriovenous shunting) and without (non-shunting) arteriovenous shunting.
  • Conditions with arteriovenous shunting, such as arteriovenous malformations and dural arteriovenous fistulas, carry significant risks.

Purpose of the Study:

  • To categorize intracranial vascular malformations based on shunting characteristics.
  • To outline the clinical presentation and treatment options for different types of cerebral vascular malformations.
  • To differentiate between malformations requiring intervention and those managed conservatively.

Main Methods:

  • Classification of intracranial vascular malformations into shunting and non-shunting types.
  • Review of clinical manifestations, including hemorrhage risk and symptoms.
  • Summary of available treatment modalities: conservative management, microneurosurgery, endovascular embolization, and radiation therapy.

Main Results:

  • Arteriovenous malformations and dural arteriovenous fistulas exhibit arteriovenous shunting, often leading to intracerebral hemorrhage and severe symptoms.
  • Cavernous malformations, developmental venous anomalies (DVA), and capillary telangiectasias lack arteriovenous shunting.
  • Cavernous malformations may necessitate operative treatment for symptomatic presentation (hemorrhage, headache, seizures), while DVAs and capillary telangiectasias are typically asymptomatic and require no intervention.

Conclusions:

  • Intracranial vascular malformations require tailored management based on their specific type and clinical presentation.
  • Prompt diagnosis and appropriate treatment are crucial for managing high-risk malformations like arteriovenous malformations and dural arteriovenous fistulas.
  • Non-shunting malformations such as DVAs and capillary telangiectasias generally have a benign course and do not require treatment.