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ARTERIOVENOUS MALFORMATION

Presented By:
Rizki Rahma Sari
Supervisor:
dr. Suhardi, Sp. BTKV

THORACIC CARDIOVASCULAR SURGERY DEPARTEMENT


OF SYIAH KUALA UNIVERSITY/
dr. ZAINOEL ABIDIN GENERAL HOSPITAL
BANDA ACEH

Introduction
Although rare, they can be fatal
Some AVMs are discovered incidentally in
asymptomatic individuals
Widely accepted surgical treatments have
significant risks (neurological deficits, death)

Definition
A congenital shunt
between the arterial and
venous systems
A tangle of abnormal
vessels (nidus)
Vary in size and location

Epidemiology
Incidence: about 1 per 100,000 per year
AVMs account for:
1-2% of all strokes
9% of subarachnoid hemorrhages

Annual risk of hemorrhage from unruptured AVM:


about 2% (poor data)

Pathogenesis
Poorly understood
Genetic variation may play a role

Clinical Manifestation
Most commonly present before age 40, some with more than
one symptom:
53% hemorrhage
30% generalized seizure
14% chronic headache
10% focal seizures
7% persistent neurological deficits
5% progressive neurological deficits
About one-fifth are discovered incidentally in asymptomatic
individuals

Diagnosis
Diagnosis is made or confirmed by diagnostic
imaging
Angiography is considered the gold standard
for diagnosis and treatment planning

Radiology Exam
Angiography
CT scan contrass
MRI cerebral/MRA

a
a. CT scan Contrass
b. MRI cerebral

Management

Medical (medicine) therapy


Surgery
Stereotactic radiosurgery
Interventional neuroradiology/endovascular
neurosurgery

Thank You

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