Women's Neurology by Mary Angela O' Neal MD;

Author:Mary Angela O' Neal MD;
Language: eng
Format: epub
Publisher: OUP Premium
Published: 2017-04-15T00:00:00+00:00

FIGURE 21.1 Plain head CT showing a large frontal temporal bleed.

What do you do now?

AVM: ARTERIOVENOUS MALFORMATION

Natural History

The timing of rupture of an arteriovenous malformation, AVM, corresponds to the timing of maximal volume changes during pregnancy. The changes in intravascular volume and cardiac output peak at 25–30 weeks, followed by further increases in cardiac output with labor and delivery and the immediate postpartum period.

Data about if pregnancy confers an increased risk of an AVM rupturing are inconclusive.1,2 However once there has been a hemorrhage related to an AVM, the risk of re-rupture is high.3 Therefore, treatment is dictated by best neurosurgical considerations rather than obstetric concerns. Our patient underwent an emergency caesarian and hemicraniectomy, done in tandem. The following day, an arteriogram showed a small AVM with an intranidal aneurysm. She underwent clot evacuation and definitive resection of the AVM (Figure 21.2).

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.