Abstract:
:In small arteriovenous malformations (AVM) with large hematomas, surgery remains the main therapeutic option. However, intraoperative identification of the AVM, feeders, and draining veins could be difficult in the environment of substantial intracerebral blood. In those selected cases, we use navigated computed tomographic angiography (CTA) for the microneurosurgical management. It is our objective to report our initial experiences. Prior to operation a conventional CTA with superficial skin fiducials placed on a patient's head was acquired for diagnostic and neuronavigation purposes. Image data were transferred to a neuronavigation device with integrated volume rendering capacities which allows a three-dimensional reconstruction of the vascular tree and the AVM to be created. In all patients the AVM was removed successfully after having been localized with CTA-based neuronavigation. Navigated CTA is helpful for the operative management of small AVMs with large hematomas. The technique allows feeding arteries to be distinguished from draining veins thereby allowing the nidus of the AVM to be identified despite the presence of substantial intracerebral blood. CTA can be easily implemented into commercial neuronavigation systems.
journal_name
Neuroradiologyjournal_title
Neuroradiologyauthors
Coenen VA,Dammert S,Reinges MH,Mull M,Gilsbach JM,Rohde Vdoi
10.1007/s00234-004-1307-ysubject
Has Abstractpub_date
2005-01-01 00:00:00pages
66-72issue
1eissn
0028-3940issn
1432-1920journal_volume
47pub_type
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