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Contribution of meningeal arteries to cerebral arteriovenous malformations
1Department of Neurosurgery, Nagoya University School of Medicine, Japan.
Abstract:
We studied 52 patients with cerebral arteriovenous malformations (AVMs) by selective angiography and found that half received supply from meningeal branches of the external carotid artery. The frequency of meningeal arterial contribution was significantly higher in superficial AVMs, especially in the temporal, parietal and occipital regions. Larger lesions and higher shunt with steal phenomena on angiography were other factors favouring a meningeal arterial contribution. Diffuse AVMs with pial arterial networks around the nidus commonly received meningeal blood supply. In the past, meningeal feeders have been thought to be congenital, but this study suggests that they may develop during growth of the AVM.
Insights
Meningeal arteries frequently supply cerebral arteriovenous malformations (AVMs), particularly superficial ones. This study suggests these meningeal feeders may develop as AVMs grow, challenging previous congenital theories.
Area of Science:
- Neurology
- Vascular Neurology
- Neurosurgery
Background:
- Cerebral arteriovenous malformations (AVMs) are complex vascular lesions.
- The arterial supply of AVMs is crucial for understanding their pathophysiology and treatment.
- Meningeal arterial supply to AVMs has been historically considered congenital.
Purpose of the Study:
- To investigate the prevalence and characteristics of meningeal arterial supply in cerebral AVMs.
- To identify factors associated with meningeal contribution to AVMs.
- To explore the origin of meningeal feeders in AVMs.
Main Methods:
- Selective angiography was performed on 52 patients with cerebral AVMs.
- Angiographic data were analyzed to identify the source of arterial supply.
- Factors such as AVM location, size, and hemodynamic features were assessed.
Main Results:
- Half of the 52 patients exhibited supply from meningeal branches of the external carotid artery.
- Meningeal arterial contribution was more frequent in superficial AVMs, especially in temporal, parietal, and occipital regions.
- Larger AVMs, higher shunting, and steal phenomena were associated with increased meningeal supply.
- Diffuse AVMs with surrounding pial networks commonly received meningeal blood supply.
Conclusions:
- Meningeal arteries are a significant source of blood supply for cerebral AVMs.
- Superficial AVMs and specific anatomical locations are predisposed to meningeal supply.
- The findings suggest that meningeal feeders may be acquired rather than congenital, developing with AVM growth.