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Spontaneous Intracranial Haemorrhage Caused by a Non-aneurysmal Brain Vascular Malformation
Published online by Cambridge University Press: 16 January 2025
Summary
Emergency management of intracranial haemorrhage due to AVMs, DAVFs, and cavernomas involves addressing both the haemorrhage consequences and the underlying vascular lesion. Clinical evaluation and diagnostic workup identify factors necessitating urgent intervention and define the vascular lesion. Urgent intervention may involve ICH management with increased ICP or CSF drainage for acute hydrocephalus. Definitive intervention for the vascular lesion may coincide with or follow evacuation of the intracranial haematoma. Careful considerations and precautions are taken independently or concurrently with the vascular lesion. Indications and timing for AVM intervention involve determining the bleeding source, evaluating mass effect, and assessing the utility of existing ICH for microsurgical AVM resection. Modified microsurgical techniques ensure safety. DAVF intervention with ICH or ASDH requires urgent endovascular treatment and surgical nuances. Cavernoma intervention follows straightforward indications and timing, while brainstem cavernomas require careful consideration of early intervention. Aftercare and a team approach are vital.
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- Online ISBN: 9781009439367Publisher: Cambridge University PressPrint publication: 30 January 2025
References
Unterberg, AW, Orakcioglu, B (2019). Spontaneous Intracranial Haematoma. In Kirollos, RW, Helmy, A, Thomson, S, Hutchinson, PJ, eds., Oxford Textbook of Neurological Surgery, 1st ed.; Oxford: Oxford University Press, pp. 643–649.Google Scholar
Weerakkody, RA, Trivedi, R, Santarius, T, Kirollos, RW (2009). Intracranial Arteriovenous Malformations. British Journal of Neurosurgery, 21, 1–5.Google Scholar
Morgan, M (2019). Arteriovenous Malformation and Dural Arteriovenous Fistulae. In Kirollos, RW, Helmy, A, Thomson, S, Hutchinson, PJ, eds., Oxford Textbook of Neurological Surgery, 1st ed.; Oxford: Oxford University Press, pp. 591–613.Google Scholar
Patel, H, Beijnum, J (2019). Cavernoma and Angiographically Occult Lesions. In Kirollos, RW, Helmy, A, Thomson, S, Hutchinson, PJ, eds., Oxford Textbook of Neurological Surgery, 1st ed.; Oxford: Oxford University Press, pp. 651–657.Google Scholar
Kirollos, RW, Tyagi, AK, Ross, SA, van Hille, PT, Marks, PV (2001). Management of Spontaneous Cerebellar Haematomas: A Prospective Treatment Protocol. Neurosurgery, 49(6), 1378–1386.CrossRefGoogle ScholarPubMed
Trivedi, R, Kirollos, R, Whitfield, P (2009). Considerations in the Management of Cerebral Arterio-venous Malformations. Advances in Clinical Neuroscience and Rehabilitation, 9(3), 26–29.Google Scholar
Budohoski, KP, Mohan, M, Millar, Z, et al. (2021). Longitudinal Changes in Size of Conservatively Managed Flow-Related Aneurysms Associated with Brain Arteriovenous Malformations. World Neurosurgery, 154, e754–e761.CrossRefGoogle ScholarPubMed
Marcus, H, Weerakkody, RA, Trivedi, R, Santarius, T, Kirollos, R (2010). Management of Arteriovenous Malformations (AVMs) Presenting with Intracranial Haemorrhage: The Role of Subacute Resection. British Journal of Neurosurgery, 24(1), 95.CrossRefGoogle ScholarPubMed
Barone, DG, Marcus, HJ, Guilfoyle, MR, et al. (2017). Clinical Experience and Results of Microsurgical Resection of Arteriovenous Malformation in the Presence of Space-Occupying Intracerebral Hematoma. Neurosurgery, 81(1), 75–86.CrossRefGoogle ScholarPubMed
Al-Mahfoudh, R, Kirollos, R, Mitchell, P, et al. (2015). Surgical Disconnection of the Cortical Venous Reflux for High-Grade Intracranial Dural Arteriovenous Fistulas. World Neurosurgery, 83(4), 652–656.CrossRefGoogle ScholarPubMed
Morgan, MK, Guilfoyle, M, Kirollos, R, Heller, GZ (2019). Remodeling of the Feeding Arterial System after Surgery for Resection of Brain Arteriovenous Malformations: An Observational Study. Neurosurgery, 84(1), 84–94.CrossRefGoogle ScholarPubMed
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