Radiologic assessment of brain arteriovenous malformations: what clinicians need to know.
Brain arteriovenous malformations (AVMs) are abnormal vascular connections within the brain that are presumably congenital in nature. There are several subgroups, the most common being glomerular type brain AVMs, with fistulous type AVMs being less common. A brain AVM may also be a part of more extensive disease (eg, cerebrofacial arteriovenous metameric syndrome). When intracranial pathologic vessels are encountered at cross-sectional imaging, other diagnoses must also be considered, including large developmental venous anomalies, malignant dural arteriovenous fistulas, and moyamoya disease, since these entities are known to have different natural histories and require different treatment options. Several imaging findings in brain AVMs have an impact on decision making with respect to clinical management; the most important are those known to be associated with risk of future hemorrhage, including evidence of previous hemorrhage, intranidal aneurysms, venous stenosis, deep venous drainage, and deep location of the nidus. Other imaging findings that should be included in the radiology report are secondary effects caused by brain AVMs that may lead to nonhemorrhagic neurologic deficits, such as venous congestion, gliosis, hydrocephalus, or arterial steal.
Neuroradiology Division, Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G1X8. sasikhan@gmail.com
Sasikhan
S
Geibprasert
Sirintara
S
Pongpech
Pakorn
P
Jiarakongmun
Manohar M
MM
Shroff
Derek C
DC
Armstrong
Timo
T
Krings
D002533:Cerebral Angiography / Q000379:methods*; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*