Search Our Scientific Publications & Authors

Braz J Anesthesiol 2021 May 10. Epub 2021 May 10.

Hospital Universitario 12 de Octubre, Madrid, Spain.

This report describes the case of a pregnant woman who arrived for pre-anesthetic assessment of External Cephalic Version (ECV) for fetus in breech presentation and cesarean section in case of ECV failure. Although the technique seems simple, attempts to rotate the fetus can result in elevated intracranial pressure, which might cause malformation bleeding. The most appropriate anesthetic technique in cases of arteriovenous malformations during C-sections has not been determined. Read More

Rev Bras Ginecol Obstet 2021 Apr 12;43(4):323-328. Epub 2021 May 12.

Department of Obstetrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Complete hydatidiform mole (CHM) is a rare type of pregnancy, in which 15 to 20% of the cases may develop into gestational trophoblastic neoplasia (GTN). The diagnostic of GTN must be done as early as possible through weekly surveillance of serum hCG after uterine evacuation. We report the case of 23-year-old primigravida, with CHM but without surveillance of hCG after uterine evacuation. Read More

Acta Neurochir Suppl 2021 ;132:113-122

Department of Neurosurgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

Introduction: Dural arteriovenous fistulas (dAVFs) account for 10-15% of all intracranial arteriovenous lesions. Different classification strategies have been proposed in the course of the years. None of them seems to guide the treatment strategy. Read More

Acta Neurochir Suppl 2021 ;132:107-112

Neurosurgery Unit, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.

The actual role of preoperative embolization of brain arteriovenous malformations (AVMs) is undervalued.The present study aims to describe the effectiveness, safety, technics, and results of the endovascular-based functional downgrading of brain AVMs.Data regarding 31 Spetzler-Martin (SM) grade III AVMs that consecutively underwent a combined endovascular-surgical treatment were reviewed. Read More

Acta Neurochir Suppl 2021 ;132:101-106

Department of Neurosurgery, ASST Ovest Milanese, Legnano, Italy.

Brain arteriovenous malformations (AVMs) classification has been the subject of extensive discussion. The aim of our work was to review the main classification schemes proposed in the literature, which can be summarized in four main groups: (a) traditional schemes oriented to evaluate the operability of AVMs have been joined by (b) specific classifications that evaluate the outcome and the predictability of obliteration of other treatment modalities and (c) others that evaluate the outcome of intracerebral hemorrhages in ruptured AVMs. Eventually, (d) topographical classifications that categorize the subtypes of AVMs located in specific anatomical regions have been drawn. Read More

Acta Neurochir Suppl 2021 ;132:91-100

Department of Neurosurgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.

Background: Eloquent location of a brain arteriovenous malformation (BAVM) is known to increase the surgical risk. Surgical removal of such BAVMs is challenging. Useful indicators for the safe removal of eloquent BAVMs are needed. Read More

Acta Neurochir Suppl 2021 ;132:77-81

Department of Neurosurgery, Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore, Milan, Italy.

In AVM surgery perioperative complications can arise and can have serious perioperative consequences. Surgically related complications in AVM treatment, in many cases, can be avoided by paying attention to details:1. Careful selection of the patient: - addressing a patient with eloquent AVM to Gamma Knife treatment - preoperative treatment with selective embolization of the accessible deep feeders - preoperative gamma knife or embolize those patient with an over-expressed venous pattern2. Read More

Acta Neurochir Suppl 2021 ;132:71-76

National Institute of Clinical Neurosciences, Budapest, Hungary.

Background And Purpose: Brain arteriovenous malformations (AVM) are uncommon vascular lesions with the risk of hemorrhage, epileptic seizures, neurological deficits, and headache. Comparing the risks of the natural history and that of preventive treatment, a recent study has found observation more beneficial than treatment for unruptured AVMs. This study, however, did not consider the long-term impact of carrying a brain AVM on everyday activities. Read More

Pediatr Cardiol 2021 May 8. Epub 2021 May 8.

Pediatric Heart Center, Icahn School of Medicine At Mount Sinai, New York, NY, USA.

Vein of Galen aneurysmal malformation (VGAM) is a rare anomaly associated with poor outcomes from high output cardiac failure and neurologic complications. Studies addressing fetal cardiovascular status and outcomes in this population are limited. A single-center retrospective review was conducted on patients with a prenatal diagnosis of VGAM who underwent a fetal echocardiogram between January 2015 and July 2019. Read More

J Neurosurg 2021 May 7:1-10. Epub 2021 May 7.

2Division of Neuroradiology, Department of Medical Imaging, and.

Objective: The aim of this study was to 1) compare the safety and efficacy of acute targeted embolization of angiographic weak points in ruptured brain arteriovenous malformations (bAVMs) versus delayed treatment, and 2) explore the angioarchitectural changes that follow this intervention.

Methods: The authors conducted a retrospective analysis of a prospectively acquired database of ruptured bAVMs. Three hundred sixteen patients with ruptured bAVMs who presented to the hospital within 48 hours of ictus were included in the analysis. Read More

Mayo Clin Proc 2021 05;96(5):1157-1164

Department of Neurological Surgery, Mayo Clinic, Rochester, MN; Department of Radiation Oncology, Mayo Clinic, Rochester, MN. Electronic address:

Objective: To determine whether biological effective dose (BED) was predictive of obliteration after stereotactic radiosurgery (SRS) for cerebral arteriovenous malformations (AVMs).

Patients And Methods: We studied patients undergoing single-session AVM SRS between January 1, 1990, and December 31, 2014, with at least 2 years of imaging follow-up. Excluded were patients with syndromic AVM, previous SRS or embolization, and patients treated with volume-staged SRS. Read More

Mayo Clin Proc 2021 05;96(5):1114-1116

Department of Neurosurgery and Neuro-oncology, CHU Lille, France.

Neurosurgery 2021 May 6. Epub 2021 May 6.

Department of Neurosurgery, Geisinger, Danville, Pennsylvania, USA.

Background: The R2eD AVM scoring system has been recently proposed to predict the risk of hemorrhagic presentation of brain arteriovenous malformations (AVMs).

Objective: To perform the first external validation of this R2eD AVM score.

Methods: Over a retrospective 10-yr period from 2009 to 2019, 122 patients with brain AVMs fit the inclusion criteria. Read More

Neurosurgery 2021 May 6. Epub 2021 May 6.

Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Oper Neurosurg (Hagerstown) 2021 May 6. Epub 2021 May 6.

Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Tentorial margin arteriovenous malformations (AVMs) at the cerebello-mesencephalic fissure are deep lesions, which can be safely resected via a lateral supracerebellar infratentorial approach. This video illustrates the case of a patient who presented with hemorrhage from a tentorial AVM. He was managed in the hybrid neurovascular operating room with Onyx (Medtronic) embolization of a superior cerebellar artery feeder followed by resection of the AVM, which included cerebellar relaxation from lumbar cerebrospinal fluid (CSF) drainage and lateral positioning. Read More

Childs Nerv Syst 2021 May 6. Epub 2021 May 6.

Division of Interventional Neuroradiology, Hospital de Pediatría Juan P. Garrahan, Buenos Aires, Argentina.

Cerebral proliferative angiopathy (CPA) is an infrequent vascular malformation. It is composed of a nidus, arterial feeders, and venous drainage. Some special features differentiate it from the common arteriovenous malformations (AVM). Read More

Biomed Res Int 2021 14;2021:6686167. Epub 2021 Apr 14.

Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China.

Whether the use of endovascular embolization could provide additional benefits in patients treated with stereotactic radiosurgery (SRS) for intracranial arteriovenous malformations (IAVMs) remains controversial. The current meta-analysis was conducted to assess the efficacy and safety of SRS with and without prior endovascular embolization in patients with IAVMs. The electronic databases of PubMed, EmBase, and Cochrane Library were systematically searched for eligible studies published from inception to August 12, 2020. Read More

Proc (Bayl Univ Med Cent) 2021 Feb 5;34(3):399-400. Epub 2021 Feb 5.

Division of Gastroenterology, Department of Medicine, Baylor Scott and White Medical Center - TempleTempleTexas.

Arteriovenous malformations (AVM) are most commonly found in the gastrointestinal tract, and presentation can range from asymptomatic to massive gastrointestinal hemorrhage. This case highlights a unique presentation of AVMs. During a screening colonoscopy, a 5-cm mass was discovered in the transverse colon encompassing 25% to 50% of the circumference of the lumen. Read More

BMJ Case Rep 2021 May 4;14(5):1-3. Epub 2021 May 4.

Radiology Department, Private Koru Hospital, Ankara, Turkey.

Herein, we describe the use of a novel multiplug flow control technique for the curative transarterial embolisation of cerebrovascular malformations using liquid embolic agents (LEAs). The idea behind the use of this technique is to substantially control or arrest flow during LEA injection, with multiple plugs simultaneously formed from microcatheters that are placed within all or multiple feeders, so that the penetration of LEAs is facilitated, with flow control decreasing the washout of a malformation. This technique enables the complete occlusion of a vascular malformation in a shorter injection time than that in other methods because penetration is achieved faster. Read More

J Oral Implantol 2021 May 4. Epub 2021 May 4.

Aix-Marseille Universite Faculte de Medecine Oral surgery 264 Rue Saint-Pierre FRANCE Marseille 13385 Aix-Marseille Universite Faculte de Medecine.

Purpose: Mandibular arteriovenous malformations are rare congenital malformations which require multidisciplinary care. Implant-supported rehabilitation of significant bone defect after embolization and resection is poorly described in the literature.

Clinical Report: We present the case of a 24 year-old patient with a right sided mandibular arteriovenous malformations diagnosed after massive hemorrhage and treated by embolization and resection surgery. Read More

Radiographics 2021 May-Jun;41(3):742-761

From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO 63110 (K.M.M., C.A.R., M.Z.R., K.L.S., D.D.P., S.B.); Department of Radiology, University of California-San Francisco, San Francisco, Calif (T.S.H.); and Department of Radiology, Centro Rossi, Buenos Aires, Argentina (S.E.R.).

, which is defined as expectoration of blood from the alveoli or airways of the lower respiratory tract, is an alarming clinical symptom with an extensive differential diagnosis. CT has emerged as an important noninvasive tool in the evaluation of patients with hemoptysis, and the authors present a systematic but flexible approach to CT interpretation. The first step in this approach involves identifying findings of parenchymal and airway hemorrhage. Read More

Ideggyogy Sz 2021 Mar;74(3-4):126-128

Neuroradiology Division, Department of Radiology and Medical Informatics, Geneva University Hospitals, Geneva, Switzerland.

The subtypes of brain arteriovenous malformations, with direct, single-hole fistulas without co-existing nidus are not described as existing entities inside the brain parenchyma but on the pial surface. True parenchymal arteriovenous malformations present with nidal structure, even if they are small, whereas surface lesions may present a direct fistulous configuration. In this case of midbrain haemorrhage a direct arteriovenous fistula was detected at the level of the red nucleus between a paramedian midbrain perforator artery and a paramedian parenchymal vein, with pseudo-aneurysm formation at the fistulous connection, without signs of adjacent nidus structure. Read More

Chin Neurosurg J 2021 May 1;7(1):23. Epub 2021 May 1.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100079, People's Republic of China.

Background: We sought to explore an optimal clinical nursing mode following a hybrid surgery for cerebral arteriovenous malformation.

Methods: Patients with complex cerebral arteriovenous malformations seen in our neurosurgery department from January 2016 to December 2017 were prospectively enrolled. The hybrid surgery protocol included "angiographic diagnosis, surgical resection, and intraoperative angiographic evaluation" and "angiographic diagnosis and embolization, surgical resection, and intraoperative angiographic evaluation". Read More

J Craniofac Surg 2021 Feb 9. Epub 2021 Feb 9.

*Department of Plastic Surgery, Jinling Hospital, Bengbu Medical College, Bengbu, Anhui †Department of Burn and Plastic Surgery and Vascular Biology Lab, Jinling Hospital ‡Department of Burn and Plastic Surgery and Vascular Biology Lab, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.

Background And Objective: Defects resulted from the removal of large scars, benign tumors, severe pigmentation abnormalities, and vascular malformations, etc., in the scalp and face need to be repaired to restore the appearance. Here, the authors introduced the application of various expanded superficial temporal artery (STA) flaps in the repair of above defects. Read More

Minerva Dent Oral Sci 2021 Apr 30. Epub 2021 Apr 30.

Radiology Institute, Department of Medicine - DIMED, University of Padua, Padua, Italy.

Background: About 50% of vascular malformations are located at the head and neck region where they can usually be associated with functional and/or aesthetic limitations. Laser treatment has proven to be effective in treatment of small low-flow vascular malformations but little is known about the use of this therapy for high-flow larger arteriovenous malformations (AVMs).

Methods: a congenital high-flow vascular malformation of the upper lip had to be treated because it was causing functional impairment and deformity which were affecting the quality of life. Read More

J Surg Case Rep 2021 Apr 19;2021(4):rjab122. Epub 2021 Apr 19.

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

CLOVES syndrome is a condition characterized by congenital lipomatous overgrowth, vascular malformations, epidermal nevi and skeletal anomalies. The association of cervical arteriovenous fistula with CLOVES syndrome is extremely rare. To the best of our knowledge, only two cases were reported in the literature. Read More

Neuroimaging Clin N Am 2021 May 24;31(2):205-222. Epub 2021 Mar 24.

Department of Neuroradiology, University of Toronto, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada. Electronic address:

Brain arteriovenous malformations (AVMs) are characterized by shunting between pial arteries and cortical or deep veins, with the presence of an intervening nidus of tortuous blood vessels. These lesions present a therapeutic challenge, because their natural history entails a risk of intracranial hemorrhage, but treatment may cause significant morbidity. In this article, imaging features of AVMs on MR imaging and catheter angiography are reviewed to stratify the risk of hemorrhage and guide appropriate management. Read More

Expert Rev Cardiovasc Ther 2021 May 11:1-18. Epub 2021 May 11.

Department of Pediatrics, Sidra Heart Center, Sidra Medicine, Doha, Qatar.

: Cardiac defects that result in shunting are the most common types of congenital heart anomalies. Although these lesions can be simple, they can cause significant hemodynamic changes and can be challenging to manage in neonates and infants. Over the recent decades, the development of new transcatheter techniques and devices has made it safe and feasible to manage such defects when indicated, even in the smallest of patients. Read More

Radiol Case Rep 2021 Jun 9;16(6):1374-1377. Epub 2021 Apr 9.

Department of Radiology, Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond St, Hampstead, NW3 2QG, UK.

The appropriate identification and localization of a nidus of a high flow arteriovenous malformation is crucial to guide targeted interventional therapy. However, the nidus of a complex or previously treated HFAVM can be difficult to non-invasively demonstrate on magnetic resonance imaging alone. We describe a unique case of a 56-year-old female with a complex high flow arteriovenous malformation in which we demonstrated the feasibility of fluorodeoxyglucose positron emission tomography/computed tomography to non-invasively delineate the nidus which subsequently guided successful targeted interventional therapy. Read More

Childs Nerv Syst 2021 Apr 25. Epub 2021 Apr 25.

Department of Neurosurgery, Northwestern University School of Medicine, Lurie Children's Hospital, Chicago, IL, USA.

Purpose: Seizures are the second most common presentation of cerebral arteriovenous malformations (AVMs); pediatric patients are more likely to develop AVM-associated epilepsy. We examined the role of multimodality AVM treatment in pediatric AVM-associated epilepsy to characterize long-term epilepsy outcomes.

Methods: A retrospective chart review identified pediatric patients with AVM-associated epilepsy seen at our institution from 2005 to 2018. Read More