当前位置： SCI文献检索 > World Neurosurgery期刊下所有文献 > 18F-Fluorodeoxyglucose Positron Emission Tomography-Magnetic Resonance Monitoring of Brain Metabolic Changes in a Case of Arteriovenous Malformation-Related Steal Phenomenon Symptoms.

18F-Fluorodeoxyglucose Positron Emission Tomography-Magnetic Resonance Monitoring of Brain Metabolic Changes in a Case of Arteriovenous Malformation-Related Steal Phenomenon Symptoms.

Abstract：

BACKGROUND:Unruptured brain arteriovenous malformations (AVMs) represent a complex disease in young healthy adults. Most often AVMs are clinically silent but also can display a neurologic syndrome due to hypoperfusion/hypometabolism in perilesional brain tissue called steal phenomenon. CASE DESCRIPTION:A 34-year-old woman was admitted to a secondary neurologic center complaining of a right hemiparesis and secondarily generalized seizures. Computed tomography scan and magnetic resonance imaging of the brain showed a left prerolandic AVM without signs of acute or previous bleedings. Digital subtraction angiography confirmed a left juxta-central AVM, with a diffuse pattern, fed by hypertrophic rolandic branches from the left middle cerebral artery. An 18F-fluorodeoxyglucose positron emission tomography-magnetic resonance imaging scan was performed 3 days after the critical episode. A significant hypometabolism in parenchymal regions ipsilaterally to the AVM was detected. Two embolization sessions were performed by means of N-butyl cyanoacrylate glue. At the end of the second procedure, a decrease of the shunt-flow and AVM size was observed. Six months later, 18F-fluorodeoxyglucose positron emission tomography-magnetic resonance imaging scan showed persistent hypometabolism located in the AVM area, with a significant improvement of the cortical hemispheric hypometabolism. The patient was asymptomatic and was sent to stereotactic radiosurgery to complete the treatment. CONCLUSIONS:In clinical practice, irritative symptoms in patients with unruptured AVMs could lead to erroneous evaluations. In case of fluctuating clinical syndromes, like our case, establishing that symptoms are related to a steal phenomenon is usually difficult.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Anglani M,Cecchin D,Cester G,Simonato D,Baracchini C,Della Puppa A,Causin F

doi

10.1016/j.wneu.2019.02.167

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

276-279

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(19)30590-X

journal_volume

126

pub_type

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