Hemodynamics Associated With Intracerebral Arteriovenous Malformations: The Effects of Treatment Modalities

Vernard S. Fennell, Nikolay L. Martirosyan, Gursant S. Atwal, M. Yashar S. Kalani, Francisco A. Ponce, Gerald M Lemole, Travis M. Dumont, Robert F. Spetzler

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

The understanding of the physiology of cerebral arteriovenous malformations (AVMs) continues to expand. Knowledge of the hemodynamics of blood flow associated with AVMs is also progressing as imaging and treatment modalities advance. The authors present a comprehensive literature review that reveals the physical hemodynamics of AVMs, and the effect that various treatment modalities have on AVM hemodynamics and the surrounding cortex and vasculature. The authors discuss feeding arteries, flow through the nidus, venous outflow, and the relative effects of radiosurgical monotherapy, endovascular embolization alone, and combined microsurgical treatments. The hemodynamics associated with intracranial AVMs is complex and likely changes over time with changes in the physical morphology and angioarchitecture of the lesions. Hemodynamic change may be even more of a factor as it pertains to the vast array of single and multimodal treatment options available. An understanding of AVM hemodynamics associated with differing treatment modalities can affect treatment strategies and should be considered for optimal clinical outcomes.

Original languageEnglish (US)
Pages (from-to)611-621
Number of pages11
JournalNeurosurgery
Volume83
Issue number4
DOIs
Publication statusPublished - Oct 1 2018

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ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Fennell, V. S., Martirosyan, N. L., Atwal, G. S., Kalani, M. Y. S., Ponce, F. A., Lemole, G. M., ... Spetzler, R. F. (2018). Hemodynamics Associated With Intracerebral Arteriovenous Malformations: The Effects of Treatment Modalities. Neurosurgery, 83(4), 611-621. https://doi.org/10.1093/neuros/nyx560