Related Experiment Video
Updated: Dec 12, 2025
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
[Microsurgical resection of multiple unruptured cerebral AVMs. Case report and literature review]
Yu V Pilipenko1, V A Gorozhanin1, Sh Sh Eliava1
1Burdenko Neurosurgical Center, Moscow, Russia.
Abstract:
Multiple brain arteriovenous malformations (AVMs) are extremely rare. We report a 26-year-old patient with paroxysmal symptoms. This was the first case in our center over 10 years (0.15% of all patients with brain AVM in this period). Microsurgical resection of AVM of the left temporal lobe was carried out at the first stage (Spetzler-Martin grade I). A month later, resection of AVM of the left parietal lobe (Spetzler-Martin grade III) after preliminary endovascular embolization was carried out. Early postoperative visual and mental disorders occurred after the second surgery and completely regressed within 1 month. Control angiography after the second operation confirmed total resection of both AVMs. Thus, staged microsurgical resection of two cerebral AVMs combined with preliminary endovascular embolization of more complex AVM was effective and ensured favorable clinical result. We analyzed the features of our clinical case and compared our findings with literature data.
Insights
Multiple brain arteriovenous malformations (AVMs) are rare. This case study shows staged microsurgical resection combined with embolization effectively treated two AVMs, leading to a favorable outcome.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Neurology
Background:
- Multiple brain arteriovenous malformations (AVMs) are exceptionally rare, posing diagnostic and therapeutic challenges.
- This report details a unique case encountered at our center, representing a significant clinical rarity.
Observation:
- A 26-year-old patient presented with paroxysmal symptoms suggestive of neurological dysfunction.
- The patient had two distinct brain AVMs: one Spetzler-Martin grade I in the left temporal lobe and another Spetzler-Martin grade III in the left parietal lobe.
Findings:
- A staged surgical approach was employed, beginning with microsurgical resection of the temporal lobe AVM.
- The parietal lobe AVM underwent preliminary endovascular embolization followed by microsurgical resection.
- Postoperative temporary visual and mental deficits resolved within one month, with complete resection confirmed by angiography.
Implications:
- Staged microsurgical resection, particularly when combined with endovascular embolization for complex lesions, can be an effective treatment strategy for multiple cerebral AVMs.
- This approach offers a favorable clinical outcome, even in rare and complex presentations of brain AVMs.
- The findings contribute to the understanding of managing multiple AVMs and highlight the success of tailored, multi-modal treatment.
