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.

An unusual type of hangman's fracture.

An unusual fracture of the axis was best displayed using three-dimensional reconstruction. The fracture was noted to differ significantly from the usual "hangman's fracture" as it involved the body of C2 with subluxation of the anterior part of C2 forward on C3 and without "decompression" of the spinal canal at the C2 level. Better understanding made feasible by three-dimensional reconstruction had important treatment implications in this case.

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.

Selective transfemoral cerebral angiography of the rabbit. Technique and applications.

We describe transfemoral cerebral angiography of New Zealand white rabbits used to study the cerebral circulation, electroencephalogram, and histologic correlates of selective internal carotid infusion during embolic stroke.

Revascularization of brain arteriovenous malformations after embolization with bucrylate.

Between 1984 and 1988, 52 brain arteriovenous malformations (AVMs) were embolized in the Radiology Department of the Toronto Western Hospital. 9 were localized in the occipital lobe. There was angiographic follow-up ranging from one to four years.

Multiple cerebral arteriovenous malformations (AVMs). Review of our experience from 203 patients with cerebral vascular lesions.

From our series of 203 patients with cerebral vascular lesions, 18 (9%) could be included in the multiple arteriovenous malformation category. There were five patients with Rendu-Osler-Weber, one with Wyburn-Mason syndromes and two with concurrent arteriovenous malformations. The remaining ten patients (4%) had multiple brain arteriovenous malformations.

The rhesus monkey as an animal model for training in interventional neuroradiology.

The angiographic anatomy of the external carotid artery system in the rhesus monkey is described. Similarities and differences between human and monkey anatomy are emphasized, as well as anatomic variations and potential collateral pathways. Superselective angiography and embolization in the external carotid artery system of the rhesus monkey proved to be technically feasible and potentially represents an excellent training model for surgical neuroangiographic techniques.

A 4-F coaxial catheter system for pediatric vascular occlusion with detachable balloons.

Detachable latex balloons, preloaded coaxially in 4-F angiographic catheters, were used in eight patients, aged 6 weeks to 12 years. Successful placement of the balloon was achieved in six patients, in whom the feeding arteries arose in an oblique fashion from the aorta or main conducting arteries. Placement was not possible in two patients.

Vein of Galen aneurysmal malformations. Report of 36 cases managed between 1982 and 1988.

The authors report a series of 36 vein of Galen aneurysmal malformations (VGM) diagnosed in the paediatric (78%) and adult (22%) populations that were referred to them for therapeutic management between 1982 and 1988. The clinical signs leading to the diagnosis were variable: 36% of systemic manifestations, 22% of neurological symptoms, 17% of hydrocephaly and 11% of intracranial haemorrhage. 30 angioarchitectural analyses could be obtained and allowed to classify these VGMs into 5 different types: 44% parenchymatous AVMs, 20% mural AVFs, 30% choroidal arteriovenous fistulas, 3% dural AVFs, 7% vein of Galen varices.

[True and false cerebral venous malformations. Venous pseudo-angiomas and cavernous hemangiomas].

The authors report their classification of venous anomalies and abnormalities within the central nervous system. The so-called venous angiomas are developmental venous anomalies (D.V.

The trans-cerebral veins: normal and non-pathologic angiographic aspects.

The trans-cerebral v. have long been described, but there is little or no knowledge of their function and dysfunction. They are the site of fundamental interchange across the blood-brain barrier, a unique process within the organism.

Cerebral arteriovenous malformations with associated arterial aneurysms: hemodynamic and therapeutic considerations.

The common vascular anomalies of cerebral aneurysm and arteriovenous malformation may exist independently, or together as part of a closely related hemodynamic pairing. Resection or embolization of an AVM may be followed by a decrease in local blood flow, and lead to regression of a suitably situated proximal aneurysm. However, aneurysms located outside the angioarchitecture of the AVM, which remain flow-unrelated to the malformation, will likely not regress, and may in fact enlarge.

Trans-mesencephalic arteries and veins. Angiographic aspects in tectal vascular lesions.

The authors present the trans-mesencephalic arteries and their rôle in the differentiation of pure and secondary vein of Galen arterio-venous malformations (AVM). They illustrate the trans-mesencephalic draining veins of the so-called venous angiomas, which are normal variants, often associated with cavernous haemangiomas representing the clinically active lesion.

Cerebral arteriovenous malformations (C. AVM) and associated arterial aneurysms (AA). Analysis of 101 C. AVM cases, with 37 AA in 23 patients.

We report a series of 101 patients with cerebral arteriovenous malformations (CAVM), in which 23 cases presented with one or several arterial aneurysm(s) (AA). Each AA could be classified into distal intra-lesional, proximal or remote. Patients with CAVM + AA tend to be older and more frequently present with epilepsy, haemorrhage events and neurological deficits.

Brain arteriovenous malformations: analysis of the angio-architecture in relationship to hemorrhage (based on 152 patients explored and/or treated at the hopital de Bicêtre between 1981 and 1986).

The authors studied the charts and angiograms of 178 patients with cerebral vascular lesions. The angiographic features of these malformations could be grouped into the following categories: arterial variations, arterial aneurysms, arterial infundibulum, arterial stenosis, venous variation, venous stenosis, venous ectasia, arteriovenous fistula, transcerebral vascularization and external carotid supply. The age and sex of the patients as well as the topography and angiographic features were correlated with the incidence of hemorrhage.

[Intracranial arteriovenous vascular lesions in children. Role of endovascular technics apropos of 44 cases].

The clinical and radiological files of 44 children with intracranial arteriovenous malformations (AVM (20 AVMs with ectasia of the vein of Galen, 21 parenchymatous or choroid AVMs without ectasia of the vein of Galen and 3 congenital dural AV fistulas) were reviewed. Clinical symptoms, architecture and the used therapy are analyzed. The only specific features of the pediatric population are the clinical systemic manifestations.

Tentorial sinus. Radiologic and anatomic features of a case.

The authors report a case of tentorial sinus draining the telencephalic and diencephalic tributaries of the basal vein. Dorsally the sinus joined the straight sinus and later the confluence of the sinuses. Attention should be paid to this normal variation whenever a transtentorial surgical approach is considered.

[Dilatation of the vein of Galen. Anatomoclinical forms and endovascular treatment apropos of 14 cases explored and/or treated between 1983 and 1986].

The authors report 14 cases of vein of Galen dilatation explored and/or treated between 1983 and 1986. Three anatomic types have been individualized: the vein of Galen arterio-venous malformation (AVM) (7 cases); the cerebral AVM with vein of Galen ectasia (6 cases); the varix of the vein of Galen without AV shunt (1 case). When an AVM is present the shunt is located either in the venous wall (vein of Galen AVM) or in the brain parenchyma; in the latter the AVM drains into a tributary of the vein of Galen (cerebral AVM with vein of Galen ectasia).

Coaxial balloon-catheter device for treatment of neonates and infants.

Lack of preservation of the femoral artery after therapeutic angiography in neonates and infants has been a major obstacle to the repeated use of coaxial catheter systems. A catheter system is described that, because of its small size, has proved successful in the treatment of intracranial vascular malformations in neonates and infants by preservation of the femoral artery for future use.

Endovascular treatment of cerebral arteriovenous malformations.

The authors report their experience with the endovascular approach of AVMs. Although the follow-up is short, the approach to the lesion and the morbidity related to the technique is low. 41 patients are reviewed.

Positional vertigo and nystagmus of central origin.

Four cases are described illustrating the clinical features of positional vertigo and nystagmus due to posterior fossa tumors and a case of obstructive hydrocephalus. In these cases positional vertigo was the first and only presenting symptom of central nervous system disease. One case of subependymoma of the fourth ventricle and one with hydrocephalus had characteristic symptoms of benign positional vertigo; each showed positional nystagmus of the benign paroxysmal type.