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Platelet aggregation within cerebral arteriovenous malformations.

G R Sutherland1, M E King, C G Drake

  • 1Department of Clinical Neurological Sciences (Division of Neurosurgery), University of Western Ontario, London, Canada.

Journal of Neurosurgery
|February 1, 1988
PubMed
Summary
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Platelet aggregation is common in cerebral arteriovenous malformations (AVMs), potentially explaining their pathological features. This study used a dual-isotope method to detect platelet activity in AVM patients.

Area of Science:

  • Neurology
  • Cardiovascular Research
  • Medical Imaging

Background:

  • Cerebral arteriovenous malformations (AVMs) exhibit pathological features potentially linked to turbulent blood flow.
  • Endothelial disruption, platelet aggregation, and thrombus formation are hypothesized mechanisms in AVM pathology.

Purpose of the Study:

  • To investigate in vivo platelet aggregation within cerebral AVMs.
  • To correlate platelet aggregation with pathological findings in AVMs.

Main Methods:

  • Employed a dual-isotope scintigraphic method using indium-111-labeled platelets and technetium-99m-labeled red blood cells.
  • Quantified platelet deposition in AVMs by calculating the indium deposited to indium in the blood pool ratio (In(D)/In(BP)).
  • Correlated imaging findings with pathological examination of AVM specimens.

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Main Results:

  • Eight out of 20 patients showed significant platelet aggregation in AVMs (mean In(D)/In(BP) ratio of 0.71 ± 0.36).
  • Pathological study of seven AVMs with aggregation revealed arterial thrombosis.
  • Twelve patients had no significant platelet aggregation (mean ratio 0.02 ± 0.13); five AVMs examined showed arterial occlusion in four cases.

Conclusions:

  • Platelet aggregation is a frequent event in cerebral AVMs.
  • This aggregation may contribute to the dynamic histopathology observed in AVM lesions.
  • The findings support the hypothesis linking turbulent flow, platelet activation, and thrombosis in AVMs.