gms | German Medical Science

57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. bis 14.05.2006, Essen

Cerebellar arteriovenous malformations: frequent association of hemorrhage with aneurysms on feeding vessels

Zerebelläre arteriovenöse Malformationen: gehäuftes Auftreten von Blutungen durch AVM-assoziierten Aneurysmen

Meeting Abstract

  • corresponding author N.O. Schmidt - Klinik und Poliklink für Neurochirurgie, Universitätsklinikum HH-Eppendorf, Hamburg
  • J. Regelsberger - Klinik und Poliklink für Neurochirurgie, Universitätsklinikum HH-Eppendorf, Hamburg
  • T. Martens - Klinik und Poliklink für Neurochirurgie, Universitätsklinikum HH-Eppendorf, Hamburg
  • U. Grzyska - Abteilung für Neuroradiologie, Universitätsklinikum HH-Eppendorf, Hamburg
  • M. Westphal - Klinik und Poliklink für Neurochirurgie, Universitätsklinikum HH-Eppendorf, Hamburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 09.144

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2006/06dgnc361.shtml

Veröffentlicht: 8. Mai 2006

© 2006 Schmidt et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: It has been reported that infratentorial arteriovenous malformations (AVMs) appear to occur more frequently in conjunction with feeding vessel pedicle aneurysms and therefore are associated with a higher morbidity than supratentorial AVMs. The goal of this study was to analyze our experience in the treatment of this special subgroup of patients with cerebellar AVMs.

Methods: From our single institution AVM databank (overall number of patients n=424) a cohort of 41 patients with cerebellar AVMs managed between 1990 and 2005 were retrospectively analyzed with regard to clinical presentation, treatment regimens and outcome.

Results: Patient age ranged from 11 to 62 years with an average of 41 years. According to the Spetzler-Martin AVM grading 9 AVMs belonged to grade I, 13 to grade II, 12 to grade III, 6 to grade IV and 1 to grade V. Hemorrhage was the presenting symptom in 68% (n=28); 17% (n=7) presented with a neurological deficit and only 1 patient was asymptomatic. 32% (n=13) of the AVMs were associated with aneurysms. In this subgroup of AVMs the cause of bleeding was related to the aneurysms in 46% (n=6). Treatment regimen consisted in most cases (71%, n=29) of preoperative embolization followed by immediate surgical removal. 20% (n=8) of the patients were operated only and in 5% (n=2) treatment was performed by palliative embolisation of the AVM. No treatment option was recommended in two cases. Overall treatment associated permanent morbidity was 5% (n=2) and mortality 2,6% (n=1).

Conclusions: Our analysis underlines the frequent association of infratentorial AVMs with hemorrhage most likely due to frequent associated aneurysms. Therefore an aggressive therapeutic management is mandatory where we prefer a combined approach of endovascular embolization followed by immediate neurosurgical resection in one anesthesia. This technique enables to completely remove an AVM with minor morbidity or mortality in most cases.