Radiosurgical Treatment of a Patient With a Ruptured Arteriovenous Malformation Located in a Functionally Significant Area

• Published in: Neotložnaâ Medicinskaâ Pomoŝʹ Vol. 10; no. 4; pp. 800 - 807
• Main Authors: Tokarev, A. S., Chuvilin, S. A., Neznanova, M. V., Koinash, G. V., Matveyev, P. D.
• Format: Journal Article
• Language: English; Russian
• Published: Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department 21-01-2022
• Subjects: arteriovenous malformation; avm rupture; functional magnetic resonance imaging; gamma knife; magnetic resonance imaging; mr angiography; stereotactic radiosurgery
• ISSN: 2223-9022; 2541-8017
• DOI: 10.23934/2223-9022-2021-10-4-800-807

Arteriovenous malformations (AVMs) of the brain are quite rare vascular pathologies, but they are life-threatening, due to the risk of intracerebral hemorrhage. Stereotactic radiosurgical treatment of patients with cerebral AVM is performed in cases where surgical removal is impossible or embolization with a stable occlusive effect cannot be performed. Currently, for the diagnosis of AVM, magnetic resonance imaging (MRI) is increasingly used because of its noninvasiveness and minimal risks. When a malformation is located in a functionally significant area, then a non-invasive technique is used to assess its interposition and mapping - functional magnetic resonance imaging.
We have presented the experience of radiosurgical treatment of a 43-year-old male patient with a ruptured AVM located in the left temporal lobe, near Wernicke’s area. The patient underwent stereotactic radiosurgical treatment with Elekta Leksell Gamma Knife Perfection device, taking into account the location of the AVM in a functionally significant area, preoperative mapping was performed. After two years, according to MR angiography, the arterial component in the projection of the irradiated AVM was not visualized, which was confirmed by the data of cerebral angiography. Thus, a clinical example has demonstrated the high efficiency of MRI in the diagnosis and assessment of the results of the performed stereotactic radiosurgical treatment of AVMs.