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2016 ; 7
(ä): 79
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Total temporary occlusion of blood flow for several hours to treat a giant deep
arteriovenous malformation: A series of multiple operations to save a young life
#MMPMID27625889
Kozyrev DA
; Jahromi BR
; Hernesniemi J
Surg Neurol Int
2016[]; 7
(ä): 79
PMID27625889
show ga
BACKGROUND: The treatment of giant deep arteriovenous malformations (AVMs)
remains challenging. CASE DESCRIPTION: We report a case of giant deep AVM
diagnosed in a 9-year-old girl, for whom the AVM rupture occurred 9 years later.
At the age of 9, the girl developed mild left hemiparesis. Magnetic resonance
imaging revealed a giant deep AVM. The patient underwent one course of
stereotactic radiotherapy followed by serial imaging. At the age of 18, we
admitted her to our department with left hemiparesis and a loss of consciousness.
Computed tomography showed intracerebral hemorrhage related to AVM. The treatment
process proved challenging, with recurrent intracerebral hemorrhages. During the
second operation, we used total temporary occlusion for almost 4 hours.
Eventually, after 4 rounds of embolizations, 4 microsurgical operations, and a
month-and-a-half after admission, AVM was successfully occluded. Five years after
this treatment, the patient regained the ability to walk without assistance,
although a moderate disability with visual changes remained (Modified Rankin
Scale score 3). CONCLUSION: This case illustrates that the cumulative risk of
rupture of a high-grade AVM in young patients is evident, while treatment may
prove successful with satisfactory results.