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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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[Arteriovenous malformations and its complex management].

Sara Manzocchi Besson1, Helia Robert-Ebadi1, Giorgio La Scala2

  • 1Service d'angiologie et d'hémostase, HUG, 1211 Genève 14.

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Congenital arteriovenous malformations (AVM) are rare, present at birth, and require prompt recognition. Doppler ultrasound is key for diagnosis, with MRI aiding in detailed assessment for complex cases.

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Area of Science:

  • Vascular Surgery
  • Diagnostic Imaging
  • Pediatric Cardiology

Background:

  • Congenital arteriovenous malformations (AVM) are rare vascular anomalies present at birth.
  • These lesions can remain asymptomatic for extended periods, posing diagnostic challenges.
  • Their complex nature necessitates specialized management strategies.

Purpose of the Study:

  • To highlight the importance of general practitioners recognizing congenital AVMs.
  • To outline the diagnostic roles of Doppler ultrasound and MRI.
  • To define criteria for interventional treatment, such as embolization.

Main Methods:

  • Review of diagnostic modalities for congenital AVMs.
  • Analysis of Doppler ultrasound for characterizing anatomical and hemodynamic features.
  • Assessment of MRI's utility in defining lesion extent.

Main Results:

  • Doppler ultrasound is the primary diagnostic tool for AVMs.
  • MRI complements ultrasound by detailing lesion proximity to vital structures.
  • Embolization is reserved for specific, severe AVM presentations.

Conclusions:

  • Early suspicion and diagnosis of congenital AVMs by primary care physicians are crucial.
  • A multimodal imaging approach using Doppler ultrasound and MRI optimizes characterization.
  • Interventional treatment decisions for AVMs should be based on functional, local, or systemic complications.