Original Paper

Management of Cerebral Arteriovenous Malformations Associated with Symptomatic Congestive Intracranial Hypertension
Michael Rosenkranz^a, Jan Regelsberger^b, Hermann Zeumer^c, Ulrich Grzyska^c

Departments of
^aNeurology,
^bNeurosurgery, and
^cNeuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

Address of Corresponding Author

Eur Neurol 2008;59:62-66 (DOI: 10.1159/000109263)

  Key Words

• Therapeutic embolization
• Arteriovenous malformations
• Intracranial hypertension

  Abstract

We report on management strategies and clinical outcomes in 4 cases of acute symptomatic congestive intracranial hypertension associated with cerebral arteriovenous malformations (AVMs). Congestion resulted from high-volume shunts exhausting the drainage capacity of the cerebral venous system in 3 patients, and from sudden venous outflow obstruction in 1 patient. Two AVMs were suggested to be surgically accessible, whereas two AVMs were deemed to be inoperable. Surgically accessible AVMs were treated with embolization followed by complete surgical resection. Inoperable AVMs were treated with partial embolization. Both AVM embolization followed by surgical resection and partial AVM embolization effectively reduced intracranial pressure and achieved sustained patient recovery. Hence, an endovascular approach may be considered to manage AVM-related congestive intracranial hypertension either in combination with surgical AVM removal, or as a palliative approach in inoperable AVMs.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Michael Rosenkranz, MD
Department of Neurology, University Medical Center Hamburg-Eppendorf
Martinistrasse 52
DE-20246 Hamburg (Germany)
Tel. +49 4042 803 3770, Fax +49 4042 803 8871, E-Mail rosenkranz@uke.de

  Article Information

Received: November 29, 2006
Accepted: May 7, 2007
Published online: October 4, 2007
Number of Print Pages : 5
Number of Figures : 4, Number of Tables : 0, Number of References : 11