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Clinical Characteristics, Angioarchitecture and Management of Tectum Mesencephali Arteriovenous Malformations : A Retrospective Case Series.
Cortese, Jonathan; Delaitre, Mariette; Shotar, Eimad; Lenck, Stéphanie; Premat, Kévin; Hasboun, Dominique; Talbi, Atika; Grand, Téodor; Boch, Anne-Laure; Mathon, Bertrand; Valery, Charles-Ambroise; Drir, Mehdi; Sourour, Nader-Antoine; Clarençon, Frédéric.
Affiliation
  • Cortese J; APHP. Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France.
  • Delaitre M; Sorbonne University, Paris, France.
  • Shotar E; APHP. Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France.
  • Lenck S; APHP. Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France.
  • Premat K; APHP. Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France.
  • Hasboun D; Sorbonne University, Paris, France.
  • Talbi A; APHP. Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France.
  • Grand T; Sorbonne University, Paris, France.
  • Boch AL; APHP. Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France.
  • Mathon B; APHP. Department of Neuroradiology, Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France.
  • Valery CA; APHP. Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France.
  • Drir M; Sorbonne University, Paris, France.
  • Sourour NA; APHP. Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France.
  • Clarençon F; APHP. Department of Neurosurgery, Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France.
Clin Neuroradiol ; 32(2): 445-454, 2022 Jun.
Article in En | MEDLINE | ID: mdl-34152431
PURPOSE: Tectum mesencephali arteriovenous malformations (TM-AVMs) are rare lesions deeply located close to eloquent structures making them challenging to treat. We aimed to present clinical presentation, angiographic features and treatment strategies of TM-AVMs through a single center retrospective case series. METHODS: A TM-AVMs is defined as a nidus located in the parenchyma or on the pia mater of the posterior midbrain. Records of consecutive patients admitted with TM-AVMs over a 21-year period were retrospectively analyzed. Vascular anatomy of the region is also reviewed. RESULTS: In this study 13 patients (1.63% of the complete cohort; 10 males), mean age 48 years, were included. All patients presented with intracranial hemorrhage and two patients (15%) died after an early recurrent bleeding. Mean size of the TM-AVMs was 10.1 ± 5 mm. Multiple arterial feeders were noted in every cases. Of the patients 11 underwent an exclusion treatment, 8 via embolization (6 via arterial access and 2 via venous access) and 4 via stereotactic radiosurgery (SRS) (1 patient received both). Overall success treatment rate was 7/11 patients (64% overall; 63% in the embolization group, 25% in the SRS group). Two hemorrhagic events led to a worsened outcome, one during embolization and one several years after SRS. All other patients remained clinically stable or improved. CONCLUSION: The TM-AVMs are rare but stereotypic lesions found in a hemorrhagic context. Multiple arterial feeders are always present. Endovascular treatment seems to be an effective technique with relatively low morbidity; SRS had a low success rate but was only use in a limited number of patients.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Intracranial Arteriovenous Malformations / Radiosurgery / Embolization, Therapeutic Type of study: Observational_studies / Prognostic_studies Limits: Humans / Male / Middle aged Language: En Journal: Clin Neuroradiol Journal subject: NEUROLOGIA / RADIOLOGIA Year: 2022 Document type: Article Affiliation country: France Country of publication: Germany

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Intracranial Arteriovenous Malformations / Radiosurgery / Embolization, Therapeutic Type of study: Observational_studies / Prognostic_studies Limits: Humans / Male / Middle aged Language: En Journal: Clin Neuroradiol Journal subject: NEUROLOGIA / RADIOLOGIA Year: 2022 Document type: Article Affiliation country: France Country of publication: Germany