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Angiographically occult arteriovenous malformations.

C S Ogilvy1, R C Heros, R G Ojemann

  • 1Department of Neurosurgery, Massachusetts General Hospital, Boston.

Journal of Neurosurgery
|September 1, 1988
PubMed
Summary
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Angiographically occult arteriovenous malformations (AVMs) can be diagnosed using CT and MR imaging. Surgical removal of these AVMs is recommended for favorable outcomes and to prevent complications.

Area of Science:

  • Neurology
  • Radiology
  • Neurosurgery

Background:

  • Arteriovenous malformations (AVMs) can present with diverse neurological symptoms.
  • Some AVMs are not visualized through conventional angiography, posing diagnostic challenges.

Purpose of the Study:

  • To present cases of histopathologically proven AVMs missed by angiography.
  • To highlight the diagnostic utility of CT and MR imaging for occult AVMs.
  • To discuss clinical management and differential diagnosis of these lesions.

Main Methods:

  • Retrospective review of eight cases with histopathologically confirmed AVMs.
  • Analysis of computerized tomography (CT) and magnetic resonance (MR) imaging findings.
  • Correlation of imaging findings with clinical presentation and surgical outcomes.

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Main Results:

  • All eight patients presented with neurological symptoms like hemorrhage or seizures.
  • CT scans revealed hyperdense lesions with nonhomogeneous contrast enhancement.
  • MR imaging showed characteristic signal heterogeneity on T1- and T2-weighted images.
  • Surgical excision was performed in all cases with favorable outcomes.

Conclusions:

  • Combination of CT and MR imaging can strongly suggest angiographically occult AVMs preoperatively.
  • Surgical removal is crucial for definitive diagnosis, prevention of hemorrhage, and symptom progression.
  • Early surgical intervention in suspected cases leads to favorable patient outcomes.