Multiple cerebral arteriovenous shunts in children: report of 13 cases.

The authors present a series of 13 multiple arteriovenous malformations (MAVMs) in the pediatric population (16.9% of their overall series of brain AVMs in this group). Two types of MAVMs can be distinguished: congenital and acquired.

Hydrodynamics in vein of Galen malformations.

Forty-three patients with vein of Galen aneurysmal malformations (VGAM) referred to us for endovascular treatment between 1985 and 1990 and 335 additional cases published in the literature were reviewed with particular attention to the presence of ventricular enlargement and outcome after shunting. Hydrocephalus was the second most frequent symptom (46.8%); it is more frequent in infants (73%) than in children, adults (30%) or neonates (15%).

[Role of embolization in the emergency treatment of ruptured cerebral arteriovenous malformations].

Embolization of cerebral arterio-venous malformations (A.V.M.

Multifocal dural arteriovenous shunts in children.

The authors present four consecutive cases of multiple dural arteriovenous (AV) shunts in children. This entity represents a rare but severe clinical situation. The etiology of the shunts is not known.

Vein of Galen malformation. Endovascular management of 43 cases.

Since 1984, 43 patients with true vein of Galen aneurysmal malformations have been referred to us and managed according to our patient selection, technique, and follow-up guidelines. Thirty-four were embolized transarterially with bucrilate (isobutyl cyanoacrylate) or enbucrilate (N-butyl cyanoacrylate) embolization. No cutdown or hypotension during or after the embolization was used and no balloon catheter was employed.

Experimental models in interventional neuroradiology.

Various experimental models have been developed to test interventional neuroradiologic techniques. Most have been used to test various devices and embolic materials, and a small number of models have been designed for teaching or training purposes. Experimental models in endovascular techniques have seldom been used to stimulate disease processes in order to facilitate their understanding.

Endovascular treatment of intracerebral arteriovenous malformations: experience in 49 cases.

The authors report the results of treatment in 49 consecutive patients with brain arteriovenous malformations (AVM's) who underwent therapeutic embolization with liquid adhesive agents between 1984 and 1988 at the Toronto Western Hospital. Thirty-three patients had no other treatment and were followed up with angiography at 2 years and clinically from 2 to 6 years. Of the other 16 patients, 10 had adjunctive radiosurgery and six underwent surgical resection following embolization.

Embolization of dissecting aneurysms of the petrocavernous segment of the carotid artery.

The authors present two patients who had dissecting aneurysms of the petrocavernous segment of the internal carotid artery. They successfully treated the condition with balloon embolization of the artery proximal to the aneurysm.

Congestive cardiac manifestations from cerebrocranial arteriovenous shunts. Endovascular management in 30 children.

Since 1984 we have been involved in the management of 30 children who had cardiac manifestations secondary to cerebrocranial arteriovenous shunts. Aneurysm malformation of the vein of Galen was the most common vascular lesion observed (73% of cases). In 77% of the patients the cardiac symptoms were the main presenting complaint.

Jugular foramen arteriovenous shunt with subarachnoid hemorrhage.

The authors report the case of a 37-year-old man with an extracerebral arteriovenous fistula at the skull base, revealed by subarachnoid and intraventricular hemorrhage. The malformation was fed by the neuromeningeal trunk of the ascending pharyngeal artery and drained into left laterobulbar veins. Embolization with bucrylate was performed and occluded totally the shunting zone.

Complete persistence of the hyoido-stapedial artery in man. Case report. Intra-petrous origin of the maxillary artery from ICA.

The authors report a case of total persistence of the hyoïdo-stapedial artery (HSA) discovered fortuitously in an adult. The external carotid artery terminated as the superficial temporal, middle deep temporal and transverse facial arteries; the HSA arose from the intrapetrous internal carotid artery, coursed within the middle ear and the middle cranial fossa where it gave off the middle meningeal artery before leaving the skull via the foramen spinosum to become the maxillary artery.

Acquired mural (dural) arteriovenous shunts of the vein of Galen. Report of 4 cases.

4 patients with acquired arteriovenous shunts located in the wall of an ectatic vein of Galen (VG) are reported. They represent so-called VG dural arterio-venous malformations (DAVM). These shunts involve the vasa vasorum normally present in the VG wall.

Deep venous drainage in great cerebral vein (vein of Galen) absence and malformations.

We report two types of venous patterns associated with great cerebral vein (vein of Galen) absence or unavailability. Developmental venous anomalies or vein of Galen arteriovenous malformations (VGAM) serve as an illustrative material. A diencephalic pattern that collects the thalamo-striate veins into the tentorial sinus is recognized in most VGAM.

The variable presentations of craniocervical and cervical dural arteriovenous malformations.

The authors reviewed four patients with dural arteriovenous malformations in the upper spinal axis. Two were at the foramen magnum and two were lower cervical. The patients presented with subarachnoid hemorrhage, a slowly progressive cervical myelopathy, a rapidly progressive thoracic myelopathy, and tinnitus with a sixth nerve palsy.

Aberrant carotid artery: recognition on high resolution computed tomography.

In the investigation of a pulsatile retrotympanic mass it is important to recognize the high resolution computed tomography findings of an aberrant internal carotid artery. These include an absent exocranial opening of the carotid canal and a tubular density coursing along the medial wall of the middle ear in continuity with the horizontal carotid canal through a dehiscence of the lateral carotid plate. Our report highlights an unusual variation where two anomalous arteries, an aberrant internal carotid and an inferior tympanic to petrous carotid anastomoses, course through the middle ear.

[Anesthetic management for arteriographic evaluation and endovascular treatment in children with arteriovenous malformation of the vein of Galen].

In a series of 23 consecutive patients under 3 years old with VGAVM managed in Bicêtre from 1985 to 1990, 19 have been angiographically explored and 16/19 embolized (35 total procedures). Anaesthetic management must be adapted to the consequences of this disease: heart failure in newborns, intracranial hypertension in infants and the technical constraints of anaesthesiology in infants during neuroradiological explorations. Our results are satisfactory when compared to the classical bad prognosis of the disease: 90% of all the heart failures were ameliorated or cured; 10 infants are anatomically cured.

Angiography in the investigation of spinal dural arteriovenous fistula. A protocol with application of the venous phase.

The authors present their protocol for spinal angiography in their investigation of dural arteriovenous fistula (DAVF). The protocol has been used in approximately 120 patients from 1983 to the present at Bicetre Hospital. The approach is based on the fact that venous congestion is responsible for the myelopathy of DAVF.

Venous anomalies and abnormalities of the posterior fossa.

The authors report a series of 16 patients with venous anomalies or abnormalities of the posterior fossa studied by angiography, CT and/or MRI. We believe that so-called venous angiomas are extreme anatomic variants that drain normal territories, and we prefer to call them developmental venous anomalies (DVAs). Posterior fossa DVAs, like the supratentorial ones are classified according to their drainage into deep and superficial types.

Posterior fossa arteriovenous malformations. Angioarchitecture in relation to their hemorrhagic episodes.

Classically, posterior fossa arteriovenous malformations (PF-AVMs) have been considered as lesions with high tendency to bleed. However, careful analysis of clinical and autopsy data from the literature demonstrate that in fact the incidence of hemorrhage is similar in infratentorial and supratentorial locations. The clinical perception that most of the diagnosed PF-AVMs had bled does not mean that they have a high risk of hemorrhage.