Diagnóstico de las malformaciones arteriovenosas cerebrales

Abstract

Arteriovenous malformations (AVM) of the brain are, at present, entities that are difficult to diagnose owing to the variations in their clinical presentation and the different localisations in the central nervous system. Their most frequent clinical forms are haemorrhage, which is typically located in the intraparenchymatous region, seizures and, less frequently, vascular headache and progressive neurological deficit. Several imaging studies with different resolutions must be performed for a final and conclusive diagnosis of an AVM, and brain angiography remains the first choice procedure, both in diagnosis and in planning management. The more recent use of functional studies has enabled us to better evaluate the haemodynamic characters of AVM and the repercussion on the surrounding brain tissue. The use of transoperative angiography, as a complement in resective surgery, allows us to determine the level of resection before closing the skull and, thus, to correct technical defects. It therefore diminishes the post operative complications derived from remnants of the lesion.