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Arteriovenous Malformation
Luke L. Linscott, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Arteriovenous malformation (AVM): High-flow vascular malformation with AV shunting through complex nidus of arterioles & venules (without intervening capillary bed)

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Angiographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. de Castro-Afonso LH et al: Association between draining vein diameters and intracranial arteriovenous malformation hemorrhage: a multicentric retrospective study. Neuroradiology. 62(11):1497-505, 2020
                                        2. Hong S et al: Long-term outcomes in pediatric unruptured brain arteriovenous malformation treated by nonconservative management: a single center analysis. Childs Nerv Syst. 35(8):1363-9, 2019
                                        3. Ai X et al: The factors associated with hemorrhagic presentation in children with untreated brain arteriovenous malformation: a meta-analysis. J Neurosurg Pediatr. 23(3):343-54, 2018
                                        4. Huang Z et al: A reanalysis of predictors for the risk of hemorrhage in brain arteriovenous malformation. J Stroke Cerebrovasc Dis. 27(8):2082-7, 2018
                                        5. Hodel J et al: Intracranial arteriovenous shunting: detection with arterial spin-labeling and susceptibility-weighted imaging combined. AJNR Am J Neuroradiol. 38(1):71-6, 2017
                                        6. Jimenez JE et al: Role of follow-up imaging after resection of brain arteriovenous malformations in pediatric patients: a systematic review of the literature. J Neurosurg Pediatr. 19(2):149-56, 2017
                                        7. Kodera T et al: Evaluation of obliteration of arteriovenous malformations after stereotactic radiosurgery with arterial spin labeling MR imaging. Br J Neurosurg. 31(6):641-7, 2017
                                        8. Ma L et al: Subsequent haemorrhage in children with untreated brain arteriovenous malformation: higher risk with unbalanced inflow and outflow angioarchitecture. Eur Radiol. 27(7):2868-76, 2017
                                        9. Magro E et al: Responses to ARUBA: a systematic review and critical analysis for the design of future arteriovenous malformation trials. J Neurosurg. 1-9, 2016
                                        10. Mohr JP et al: Medical management with or without interventional therapy for unruptured brain arteriovenous malformations (ARUBA): a multicentre, non-blinded, randomised trial. Lancet. 383(9917):614-21, 2014
                                        11. Gross BA et al: Natural history of cerebral arteriovenous malformations: a meta-analysis. J Neurosurg. 118(2):437-43, 2013
                                        12. Laakso A et al: Arteriovenous malformations: epidemiology and clinical presentation. Neurosurg Clin N Am. 23(1):1-6, 2012
                                        13. Mossa-Basha M et al: Imaging of cerebral arteriovenous malformations and dural arteriovenous fistulas. Neurosurg Clin N Am. 23(1):27-42, 2012
                                        14. Pradilla G et al: Surgical treatment of cranial arteriovenous malformations and dural arteriovenous fistulas. Neurosurg Clin N Am. 23(1):105-22, 2012
                                        15. Radvany MG et al: Endovascular treatment of cranial arteriovenous malformations and dural arteriovenous fistulas. Neurosurg Clin N Am. 23(1):123-31, 2012
                                        16. Schuster L et al: Changes in AVM angio-architecture and hemodynamics after stereotactic radiosurgery assessed by dynamic MRA and phase contrast flow assessments: a prospective follow-up study. Eur Radiol. 21(6):1267-76, 2011
                                        17. Wong GK et al: Computed tomographic angiography and venography for young or nonhypertensive patients with acute spontaneous intracerebral hemorrhage. Stroke. 42(1):211-3, 2011
                                        18. Niazi TN et al: Diagnosis and management of arteriovenous malformations in children. Neurosurg Clin N Am. 21(3):443-56, 2010
                                        19. Cohen-Gadol AA et al: Radiosurgery for arteriovenous malformations in children. J Neurosurg. 104(6 Suppl):388-91, 2006
                                        20. Vikkula M et al: Molecular genetics of vascular malformations. Matrix Biol. 20(5-6):327-35, 2001
                                        21. Di Rocco C et al: Cerebral arteriovenous malformations in children. Acta Neurochir (Wien). 142(2):145-56; discussion 156-8, 2000
                                        22. Rodesch G et al: Nongalenic cerebral arteriovenous malformations in neonates and infants. Review of 26 consecutive cases (1982-1992). Childs Nerv Syst. 11(4):231-41, 1995
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Pathology

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Definitions

                                                  • Arteriovenous malformation (AVM): High-flow vascular malformation with AV shunting through complex nidus of arterioles & venules (without intervening capillary bed)

                                                IMAGING

                                                • General Features

                                                  • CT Findings

                                                    • MR Findings

                                                      • Angiographic Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. de Castro-Afonso LH et al: Association between draining vein diameters and intracranial arteriovenous malformation hemorrhage: a multicentric retrospective study. Neuroradiology. 62(11):1497-505, 2020
                                                                              2. Hong S et al: Long-term outcomes in pediatric unruptured brain arteriovenous malformation treated by nonconservative management: a single center analysis. Childs Nerv Syst. 35(8):1363-9, 2019
                                                                              3. Ai X et al: The factors associated with hemorrhagic presentation in children with untreated brain arteriovenous malformation: a meta-analysis. J Neurosurg Pediatr. 23(3):343-54, 2018
                                                                              4. Huang Z et al: A reanalysis of predictors for the risk of hemorrhage in brain arteriovenous malformation. J Stroke Cerebrovasc Dis. 27(8):2082-7, 2018
                                                                              5. Hodel J et al: Intracranial arteriovenous shunting: detection with arterial spin-labeling and susceptibility-weighted imaging combined. AJNR Am J Neuroradiol. 38(1):71-6, 2017
                                                                              6. Jimenez JE et al: Role of follow-up imaging after resection of brain arteriovenous malformations in pediatric patients: a systematic review of the literature. J Neurosurg Pediatr. 19(2):149-56, 2017
                                                                              7. Kodera T et al: Evaluation of obliteration of arteriovenous malformations after stereotactic radiosurgery with arterial spin labeling MR imaging. Br J Neurosurg. 31(6):641-7, 2017
                                                                              8. Ma L et al: Subsequent haemorrhage in children with untreated brain arteriovenous malformation: higher risk with unbalanced inflow and outflow angioarchitecture. Eur Radiol. 27(7):2868-76, 2017
                                                                              9. Magro E et al: Responses to ARUBA: a systematic review and critical analysis for the design of future arteriovenous malformation trials. J Neurosurg. 1-9, 2016
                                                                              10. Mohr JP et al: Medical management with or without interventional therapy for unruptured brain arteriovenous malformations (ARUBA): a multicentre, non-blinded, randomised trial. Lancet. 383(9917):614-21, 2014
                                                                              11. Gross BA et al: Natural history of cerebral arteriovenous malformations: a meta-analysis. J Neurosurg. 118(2):437-43, 2013
                                                                              12. Laakso A et al: Arteriovenous malformations: epidemiology and clinical presentation. Neurosurg Clin N Am. 23(1):1-6, 2012
                                                                              13. Mossa-Basha M et al: Imaging of cerebral arteriovenous malformations and dural arteriovenous fistulas. Neurosurg Clin N Am. 23(1):27-42, 2012
                                                                              14. Pradilla G et al: Surgical treatment of cranial arteriovenous malformations and dural arteriovenous fistulas. Neurosurg Clin N Am. 23(1):105-22, 2012
                                                                              15. Radvany MG et al: Endovascular treatment of cranial arteriovenous malformations and dural arteriovenous fistulas. Neurosurg Clin N Am. 23(1):123-31, 2012
                                                                              16. Schuster L et al: Changes in AVM angio-architecture and hemodynamics after stereotactic radiosurgery assessed by dynamic MRA and phase contrast flow assessments: a prospective follow-up study. Eur Radiol. 21(6):1267-76, 2011
                                                                              17. Wong GK et al: Computed tomographic angiography and venography for young or nonhypertensive patients with acute spontaneous intracerebral hemorrhage. Stroke. 42(1):211-3, 2011
                                                                              18. Niazi TN et al: Diagnosis and management of arteriovenous malformations in children. Neurosurg Clin N Am. 21(3):443-56, 2010
                                                                              19. Cohen-Gadol AA et al: Radiosurgery for arteriovenous malformations in children. J Neurosurg. 104(6 Suppl):388-91, 2006
                                                                              20. Vikkula M et al: Molecular genetics of vascular malformations. Matrix Biol. 20(5-6):327-35, 2001
                                                                              21. Di Rocco C et al: Cerebral arteriovenous malformations in children. Acta Neurochir (Wien). 142(2):145-56; discussion 156-8, 2000
                                                                              22. Rodesch G et al: Nongalenic cerebral arteriovenous malformations in neonates and infants. Review of 26 consecutive cases (1982-1992). Childs Nerv Syst. 11(4):231-41, 1995