Image-guided microneurosurgical management of small cerebral arteriovenous malformations: the value of navigated computed tomographic angiography.

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

Neuroradiology

journal_title

Neuroradiology

authors

Coenen VA,Dammert S,Reinges MH,Mull M,Gilsbach JM,Rohde V

doi

10.1007/s00234-004-1307-y

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

66-72

issue

1

eissn

0028-3940

issn

1432-1920

journal_volume

47

pub_type

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