Ahead of Print: 3-D Angiography for AVM

Background: Accurate target delineation has significant impact on brain arteriovenous malformations (AVMs) obliteration, treatment success, and potential complications of stereotactic radiosurgery.

Objective: We compare the nidal contouring of AVMs using fused images of contrasted computerized tomography (CT) and magnetic resonance (MRI) with matched images of three-dimensional (3-D) cerebral angiography for Cyberknife radiosurgery (CKRS) treatment planning.

Methods: Between May 2009 and April 2012, 3-D cerebral angiography was integrated into CKRS target planning for thirty consecutive patients. The AVM nidal target volumes were delineated using fused CT and MRI scans versus fused CT, MRI, and 3-D cerebral angiography for each patient.

Ahead of Print: Indocyanine Green Videoangiography ‘In Negative’

Background: Indocianine Green Videoangiography (IGV) raises important limitations when we use it in vascular pathology, especially in cases with arterialization of the venous system like arteriovenous malformations and fistulae.

Objective: Our objective was to provide a simple procedure that overcomes the limitations of conventional IGV. We define IGV in negative (IGV-IN), so-called because in its first phase the vessel to analyze is clipped, and report 3 cases of intracranial dural arteriovenous fistulae treated with this procedure.

Methods: In 2011 we applied IGV-IN to 3 patients from our center with Borden type III intracranial arteriovenous fistulae.

Free CME Article: Spinal Glomus (Type II) Arteriovenous Malformations

Background: The natural history and treatment results for spinal glomus (Type II) arteriovenous malformations (AVMs) remain relatively obscure.

Objective: To calculate spinal glomus (Type II) AVM hemorrhages rates and amalgamate results of intervention.

Methods: We performed a pooled analysis via the PubMed database through May 2012, including studies with at least 3 cases. Data on individual patients were extracted and analyzed using a Cox proportional hazards regression model to obtain hazard ratios for hemorrhage risk factors.

Free CME Editor Choice Article: Intraoperative Angiography in Craniotomies

Background: In an era of indocyanine angiography, the routine use of intraoperative angiography (IOA) in the surgical treatment of aneurysms and vascular malformations is controversial.

Objective: To retrospectively assess the safety and efficacy of IOA and to determine predictors of surgical revision.

Methods: Between 2003 and 2011, IOA was performed during surgical treatment of 976 aneurysms, 101 arteriovenous malformations (AVMs), and 16 arteriovenous fistulas.

Free CME Article: Cerebellar Arteriovenous Malformations

Background: Anatomic diversity among cerebellar arteriovenous malformations (AVMs) calls for a classification that is intuitive and surgically informative. Selection tools like the Spetzler-Martin grading system are designed to work best with cerebral AVMs but have shortcomings with cerebellar AVMs.

Objective: To define subtypes of cerebellar AVMs that clarify anatomy and surgical management, to determine results according to subtypes, and to compare predictive accuracies of the Spetzler-Martin and supplementary systems.

Methods: From a consecutive surgical series of 500 patients, 60 had cerebellar AVMs, 39 had brainstem AVMs and were excluded, and 401 had cerebral AVMs.