Intracranial Arteriovenous Malformations

 

Part 1: The Patient-Centered Approach

Section 1: Diagnosis: “What Do I Have?”

Introduction

Chapter 1: Anatomy and Histology of Intracranial AVMs

Introduction

Cerebral Arterial Anatomy

The Circle of Willis

Cerebral Vascular Architecture

The Cerebral Venous System

Location and Classification of iAVMs

Feeding Vessels

Venous Drainage

Histology

Conclusion

References

Chapter 2: Pathology and Genetics

Introduction

Pathology

Genetics of AVMs

Conclusion

References

Chapter 3: Radiographic Anatomy: CT/MRI/Angiography and Risks

Introduction

Radiographic Anatomy of AVMs

Imaging Modalities

Conclusion

References

Chapter 4: MRI Neurovascular Evaluation: Blood Flow, Perfusion, Diffusion, and Susceptibility

Introduction

4D Flow: Quantification and Visualization of Blood Flow

Arterial Spin Labeling: Perfusion and Shunting

Diffusion: Ischemic Injury and Fiber Tractography

Susceptibility: Hemorrhage and Calcium

Conclusion

References

Section 2: Natural History: “What Does It Mean To Have An AVM?”

Introduction

Chapter 5: Natural History of Intracranial AVMs

Epidemiology

Evolution of Anatomy

Mode of Presentation

Likelihood of Hemorrhage

Risk Factors for Hemorrhage

Prognosis

Conclusion

References

Chapter 6: Aneurysms Associated With AVMs

Prevalence/Demographics

Classification

Pathogenesis and Natural History

Treatment

Conclusion

References

Chapter 7: Hemodynamic Factors: Steal/Breakthrough Bleeding

Introduction

Hemodynamic Principles

AVM Hemodynamics

Conclusion

References

Chapter 8: Classification Systems

Introduction

Surgical Classifications

Radiosurgical iAVM Classifications

Endovascular iAVM Classifications

Conclusion

References

Chapter 9: Seizures and AVMs

Introduction

Mechanisms of AVM-Related Epilepsy

Specific Diagnostic Imaging in AVM-Related Epilepsy

Treatment of AVM-Related Epilepsy

Conclusion

References

Section 3: Treatment Options: “What Can I Do About It?”

Introduction

Chapter 10: Decision Analysis for Asymptomatic Lesions

Introduction

Pathogenesis and Pathophysiology of iAVMs

Natural History

Risk Stratification and Grading Scales

Clinical Decision-Making After ARUBA

Treatment Modalities

Future Directions

Conclusion

References

Chapter 11: Decision Analysis for Symptomatic Lesions

Introduction

Natural History of Untreated iAVMs

Clinical Presentations of Patients With Symptomatic iAVMs

Treatment Strategies for Symptomatic Unruptured iAVMs

Treatment Strategies for Ruptured iAVMs

Conclusion

References

Chapter 12: Decision Analysis for AVM-Associated Aneurysms

Introduction

Classification

Natural History

Pathophysiology

Pseudoaneurysms

Flow-Related and Intranidal Aneurysms and Risk of Hemorrhage

Treatment Strategies

Conclusion

References

Chapter 13: Surgical Principles: Techniques, Goals, and Outcomes

Introduction

Preoperative Planning

Principles of Surgery

Conclusion

References

Chapter 14: Radiosurgery Principles for AVM Management: Techniques, Goals, and Outcomes

Disclosure

Goals of AVM Radiosurgery

The History of Radiosurgery

Pittsburgh SRS AVM Outcomes

The Stereotactic Radiosurgical Technique

Key Findings After Three Decades

Late Adverse Effects of Radiosurgery

Repeat Radiosurgery

The Role of Preradiosurgical Embolization

Conclusion

References

Chapter 15: Principles of Neuroendovascular Management of AVMs: Goals, Timing, Techniques, and Outcomes

Acknowledgments

Introduction

Angiographic Evaluation of iAVMs

Role of Classification in Patient Selection for Neuroendovascular Treatment

Curative Embolization

Adjunctive Embolization Before Radiosurgery

Adjunctive Embolization Before Microsurgery

Palliative Embolization

Targeted Embolization and iAVM-Associated Aneurysms

Embolic Agents

General Anesthesia vs Conscious Sedation

Outcomes of Endovascular Management of iAVMs

Conclusion

References

Chapter 16: Multimodal/Combined Therapy: Goals and Outcomes

Introduction

Embolization and Radiosurgery

Embolization and Surgery

Radiosurgery and Microsurgical Resection

Embolization, Radiosurgery, and Microsurgical Resection: Treatment of Giant iAVMs

Conclusion

References

Chapter 17: Palliation Versus Observation: Nonresectable AVMs

Defining Nonresectable iAVMs

Risks Associated With Natural History

Risks Associated With Surgery

The Role of Endovascular Therapy in Palliation

The Role of Stereotactic Radiosurgery in Palliation

The Role of Clinical Observation

Conclusion

References

Section 4: Risk Profiles: “What Are My Risks With Each Decision?”

Introduction

Chapter 18: Conservative Management (“Observation”) of Intracranial AVMs

Introduction

Initial Evaluation and Classification

Decision-Making and Risk Assessment

Weighing Risks for Patients With High-Grade AVMs

Choosing the Right Management Strategy

Conclusion

References

Chapter 19: Grading Systems and Surgical Risks

Introduction

The Spetzler-Martin Grading System

Additional AVM Grading Systems

Endovascular Grading

Radiosurgery Grading

Surgical Risks

Conclusion

References

Chapter 20: Risks of Endovascular Treatment of AVMs

Acknowledgments

Introduction

Preoperative Evaluation and Staging

Preoperative Embolization

Preradiosurgical Embolization

Embolization for Cure and Transvenous Approaches

Targeted Embolization

Palliative Embolization

Complications and Risk

Technique

Conclusion

References

Chapter 21: Risks of Combined Therapies

Introduction

Embolization Followed by Resection

Embolization Followed by Stereotactic Radiosurgery

Resection Followed by Stereotactic Radiosurgery

Stereotactic Radiosurgery Followed by Resection

Combination Treatment of Giant iAVMs

Conclusion

References

Chapter 22: Risks of Radiosurgery

Introduction

Risk of Hemorrhage Post-SRS

Acute Effects

Early Delayed Effects

Late Delayed Effects

Conclusion

References

Part 2: The Physician-Centered Approach

Section 5: AVM Management For The Emergency Medicine Physician

Introduction

Chapter 23: Emergency Management of Ruptured Intracranial AVMs

Introduction

Epidemiology and Clinical Features

Management

Conclusion

References

Section 6: AVM Management For The Anesthesiologist

Introduction

Chapter 24: Medical Comorbidities in Elective Surgery

Introduction

Comorbidity Rating Scales

Preoperative Optimization

Cardiovascular Disease

Respiratory Disease

Diabetes, Renal and Liver Disease, Fluid Status, Anemia, and Other Medical Considerations

Seizures

Headaches

Pregnancy

Social and Psychiatric Comorbidities

Venous Thromboembolism Prophylaxis

Use of Antiplatelet, Anticoagulant, and Thrombolytic Agents

Other Postoperative Medical Complications

Intracranial AVM Surgery Outcomes and Their Relation to Medical Comorbidities

Conclusion

References

Chapter 25: Anesthetic Management of Intracranial AVMs

Introduction

Presentation

Treatment

Cerebrovascular Physiology

Preoperative Management

Monitoring

Anesthetic Management

Neuroprotection

Emergence

Conclusion

References

Chapter 26: Management of Perioperative Complications During AVM Treatment

Introduction

Complications During Microsurgical Resection

Complications During Neurointerventional Procedures

Complications During the Immediate Postoperative Period

Conclusion

References

Section 7: AVM Management For The Neurointensivist

Introduction

Chapter 27: Intracranial AVMs and the Neurointensivist

Acknowledgment

Introduction

Preoperative Management of Patients With Ruptured iAVMs

Postoperative Management After iAVM Treatment

Conclusion

References

Section 8: AVMS and Pregnancy

Introduction

Chapter 28: Obstetric Considerations in AVM Management

Background

Physiologic Changes Associated With Pregnancy

Risk of iAVM Rupture and Hemorrhage in Pregnancy and the Puerperium

Diagnosis

Imaging Considerations

Treatment

Special Considerations—Medical Management

Obstetrical Mode of Delivery and Treatment

Counseling

Conclusion

References

Section 9: Anatomic and Technical Considerations For The Neurosurgeon

Introduction

Chapter 29: Preoperative, Intraoperative, and Postoperative Imaging

Introduction

Wada Testing

4D Flow MRI

SPECT

Magnetoencephalography

Intraoperative Angiography

Intraoperative ICG

Postoperative Angiography

Conclusion

References

Chapter 30: Giant Intracranial AVMs

Introduction

Epidemiology and Natural History

Indications for Treatment

Treatment Options

Conclusion

References

Chapter 31: Treatment of Eloquent Cortex AVMs

Introduction

Eloquence in AVM Grading Systems

Preoperative Evaluation of Eloquence

Intraoperative Motor and Sensory Mapping

Intraoperative Speech Monitoring

Intraoperative Visual Mapping

Neuromonitoring During Endovascular Interventions

Conclusion

References

Chapter 32: Posterior Fossa AVMs

Epidemiology and Natural History

Anatomy and Classification

Patient Selection for Treatment

Perioperative Considerations

Surgical Technique

Postoperative Management and Considerations

Outcomes and Prognosis Following Microsurgical Resection

Conclusion

References

Chapter 33: Callosal and Periventricular AVMs

Introduction

Anatomy

AVM Subtypes

Surgical Approaches and Resection Techniques

Stereotactic Radiosurgery

Conclusion

References

Chapter 34: AVMs of the Sylvian Fissure

Introduction

Sylvian AVM Classification

Treatment of Sylvian AVMs

Multimodal Approaches to Sylvian AVMs: Representative Cases

Prenidal and Intranidal Aneurysms

Conclusion

References

Chapter 35: Pediatric AVMs

Introduction

Incidence

Developmental Biology

Natural History and Common Presentations

Workup and Evaluation of iAVMs

Preoperative Embolization vs Curative Embolization

Stereotactic Radiosurgery

Resection

Surveillance

Conclusion

References

Chapter 36: Residual AVMs

Introduction

Types of Residual

Management of Residual AVMs

Conclusion

References

Chapter 37: Intraoperative AVM Rupture

Acknowledgment

Introduction

Arterial Bleeding

Venous Bleeding

Nidal Rupture

Outcomes Following Rupture

Conclusion

References

Section 10: Future Considerations

Introduction

Chapter 38: The Value of a Registry

Introduction

Issues With Randomized Control Trials and iAVMs

Clinical Registries

Quality of Patient Registries

The Electronic Health Record and Clinical Registries

The Use of Registries in Neurosurgery

Intracranial AVM Registries

Conclusion

References

Chapter 39: Imaging Predictors for Rupture

Introduction

Imaging Assessment

Location

Size

Arteries and Aneurysms

Veins

Pediatric iAVMs

Posttreatment Hemorrhage

Conclusion

References

Chapter 40: Radiosurgical Innovations

Introduction

Innovations

Case Illustration

Conclusion

References

Chapter 41: Molecular Biology and Novel Treatments of Intracranial AVMs

Acknowledgments

Cellular and Molecular Biology of AVMs

Genetic Syndromes Associated With AVM Formation

Novel Therapeutic Approaches

Conclusion

References

Chapter 42: Surgical Innovations

Introduction

Patient Selection: Indications for Surgery and Natural History

Imaging Advances

Surgical Advances

Neurocritical Care and Anesthetic Advances

Combined Therapies

Surgical Centers of Excellence

Conclusion

References

Index

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An aparitie	6 sep 2023
Autor	Philip E. Stieg, Alexander Khalessi, Michael L. J. Apuzzo
Dimensiuni	191 x 235 mm
Editura	Elsevier
Format	Hardcover
ISBN	9780323825306
Limba	Engleza
Nr pag	450