Arteriovenous Malformation - Lecture 11 Flashcards

1
Q

AVM is a

A

birth defect

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2
Q

who is more common to get AVM

A

20-30 yr olds

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3
Q

size of AVM

A

can be tiny to the size of a whole hemisphere

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4
Q

what are AVMs

A

masses of abnormal blood vessels

appear as a tangle of arteries and veins

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5
Q

high pressure arteries

A

connect directly to low pressure arteries instead of through capillaries

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6
Q

what do they all share

A

characteristic of an AV connection w/o an intervening capillary network

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7
Q

what is abnormal

A

lack of O2 or glucose to brain tissue within the fistula

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8
Q

scarred in result to

A

tiny hemorrhages

may not have been noticed except for headache

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9
Q

what occasionally occurs

A

focal deficits

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10
Q

what do focal deficits result from

A

shunting away blood from healthy brain into fistula

cerebral steal syndrome

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11
Q

what is AVM the result of

A

abnormal fetal development

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12
Q

risk of bleed with AVM

A

1-4% per yr

preceded by intense headache and/or seizure

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13
Q

smaller AVMs are more likely

A

to bleed than larger d/t elevated arterial pressure in small vessels

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14
Q

how can hemorrhages be

A

parenchymal or SA

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15
Q

bleeds are often

A

less devastating

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16
Q

why’re bleeds less devestating

A

bleeds are primarily into the malformation

only incidentally into the adjacent brain

17
Q

long term prognosis

A

good

90% surviving the first bleed

18
Q

treatment options

A

radiation

embolization

surgery

19
Q

radiation

A

indicated for very small and deep AVMs

20
Q

embolization

A

indicated for larger AVMs

21
Q

what is used in embolization

A

angiogram

AVM is given agents which help decrease the blood supply to the malformation

22
Q

surgery

A

complete resection

disallowing them from recurring again

completely removed

23
Q

surgical interventions for hemorrhagic CVA

A

craniotomy and evacuation

craniectomy and evacuation if ICP is abnormally high

preoperative management of recurrent hemorrhage and vasospasm are important

24
Q

factors associated with recovery –> HCVAs

A

poorer survivability

better fxnal recovery

25
factors associated with recovery --> ICVAs
good survivability poorer fxnal recovery
26
recovery can occur d/t
reduction of swelling or edema existence of collateral blood flow neuroplasticity
27
lacunar CVA
relatively uncommon
28
lacunar CVA has
characteristics of both ischemic and hemorrhagic CVA
29
where do lacunar CVA occur
deep white matter of the brain where tiny arterioles branch off of larger vessels vulnerable to hypertensive hemorrhage or the vessel may thicken or thrombose
30
syndromes tend to be either (lacunar CVA)
pure motor facial weakness pure sensory
31
pure motor
internal capsule - posterior limb
32
facial weakness
internal capsule - anterior limb
33
pure sensory
posterolateral thalamus
34
prognosis of lacunar CVA
tends to be good