DECISION MAKING IN EPILEPTIC AVMS

While there is no doubt about the need for surgical treatment of a ruptured arteriovenous malformation (AVM), the decision to surgically treat a patient presenting solely with seizures is more controversial.   Arteriovenous malformations (AVMs) arise from an abnormal connection between high-f...

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Main Author: Adrian Balasa
Format: Article
Language:English
Published: London Academic Publishing 2024-11-01
Series:Romanian Neurosurgery
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Online Access:http://journals.lapub.co.uk/index.php/roneurosurgery/article/view/2807
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author Adrian Balasa
author_facet Adrian Balasa
author_sort Adrian Balasa
collection DOAJ
description While there is no doubt about the need for surgical treatment of a ruptured arteriovenous malformation (AVM), the decision to surgically treat a patient presenting solely with seizures is more controversial.   Arteriovenous malformations (AVMs) arise from an abnormal connection between high-flow arterial vessels and low-flow venous vessels, resulting in a dysplastic vascular nidus within the brain tissue. The inherent flow irregularities within AVMs make them prone to rupture, which occurs in approximately half of patients. Additionally, seizures represent the second most common clinical manifestation of AVMs, presenting in 20%–45% of individuals with these lesions.   This paper investigates the angiographic and MRI features of arteriovenous malformations that present with epilepsy, and discusses the surgical considerations in managing these patients and integration of multimodal approach focusing on the standard microsurgical techniques utilized.   Patients presenting with seizures as the primary symptom of an arteriovenous malformation carry a higher surgical risk compared to those presenting with haemorrhage.   Several factors have been associated with an increased risk of seizures in patients with arteriovenous malformations (AVMs). These include male gender, younger patient age, AVMs located in the frontal or temporal lobes, AVMs situated in the brain cortex, superficial venous drainage, a superficial temporal lobe AVM nidus, fistulous AVMs, and AVMs with venous stenosis.   Surgical treatment is the recommended approach for patients with Spetzler-Martin grade I–III arteriovenous malformations. Resecting an unruptured brain arteriovenous malformation in a patient presenting only with epilepsy is a complex decision that requires a thorough understanding of the lesion’s anatomy, the patient’s history, and the neurosurgeon’s skills.
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spelling doaj-art-951f1c863d88460d8a5dfb814fc3e6e12024-11-14T15:47:12ZengLondon Academic PublishingRomanian Neurosurgery1220-88412344-49592024-11-0138Special Issue10.33962/roneuro-2024-083DECISION MAKING IN EPILEPTIC AVMSAdrian Balasa While there is no doubt about the need for surgical treatment of a ruptured arteriovenous malformation (AVM), the decision to surgically treat a patient presenting solely with seizures is more controversial.   Arteriovenous malformations (AVMs) arise from an abnormal connection between high-flow arterial vessels and low-flow venous vessels, resulting in a dysplastic vascular nidus within the brain tissue. The inherent flow irregularities within AVMs make them prone to rupture, which occurs in approximately half of patients. Additionally, seizures represent the second most common clinical manifestation of AVMs, presenting in 20%–45% of individuals with these lesions.   This paper investigates the angiographic and MRI features of arteriovenous malformations that present with epilepsy, and discusses the surgical considerations in managing these patients and integration of multimodal approach focusing on the standard microsurgical techniques utilized.   Patients presenting with seizures as the primary symptom of an arteriovenous malformation carry a higher surgical risk compared to those presenting with haemorrhage.   Several factors have been associated with an increased risk of seizures in patients with arteriovenous malformations (AVMs). These include male gender, younger patient age, AVMs located in the frontal or temporal lobes, AVMs situated in the brain cortex, superficial venous drainage, a superficial temporal lobe AVM nidus, fistulous AVMs, and AVMs with venous stenosis.   Surgical treatment is the recommended approach for patients with Spetzler-Martin grade I–III arteriovenous malformations. Resecting an unruptured brain arteriovenous malformation in a patient presenting only with epilepsy is a complex decision that requires a thorough understanding of the lesion’s anatomy, the patient’s history, and the neurosurgeon’s skills. http://journals.lapub.co.uk/index.php/roneurosurgery/article/view/2807DECISION MAKING IN EPILEPTIC AVMS
spellingShingle Adrian Balasa
DECISION MAKING IN EPILEPTIC AVMS
Romanian Neurosurgery
DECISION MAKING IN EPILEPTIC AVMS
title DECISION MAKING IN EPILEPTIC AVMS
title_full DECISION MAKING IN EPILEPTIC AVMS
title_fullStr DECISION MAKING IN EPILEPTIC AVMS
title_full_unstemmed DECISION MAKING IN EPILEPTIC AVMS
title_short DECISION MAKING IN EPILEPTIC AVMS
title_sort decision making in epileptic avms
topic DECISION MAKING IN EPILEPTIC AVMS
url http://journals.lapub.co.uk/index.php/roneurosurgery/article/view/2807
work_keys_str_mv AT adrianbalasa decisionmakinginepilepticavms