Acta neurochirurgica
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Acta neurochirurgica · Dec 2003
Cerebral arteriovenous malformations: influence of angioarchitecture on bleeding risk.
To evaluate the angioarchitecture of cerebral arteriovenous malformations (cAVMs) with special regard to its influence on the risk of intracranial haemorrhage. ⋯ Various angiographic features were correlated with the occurrence of intracranial haemorrhage in patients with cerebral AVMs. In addition to the well-known factors influencing the bleeding risk of cAVMs like size, pattern of venous drainage and location within the brain our data demonstrate the importance to look at the diameter of the main feeder and the number of draining veins showing a better correlation.
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Acta neurochirurgica · Dec 2003
Asymptomatic shunt malfunction detected fortuitously by observation of papilloedema.
Significant shunt malfunction is nearly always followed by headache, nausea, vomiting, lethargy and/or visual disturbances. In many cases there are also signs of raised intracranial pressure on computed tomography (CT). In six hydrocephalic, shunt dependent children (8-14,5 years) with no or slight symptoms shunt malfunction was detected because of papilloedema. ⋯ In five children the oedema disappeared after shunt-revision without any visual reduction, but in one the visual deficit did not improve. Older children can have shunt malfunction leading to increased intracranial pressure, with no or discrete symptoms and no obvious ventricular dilatation but with asymptomatic papilloedema. Ophthalmoscopy can therefore be of great value at routine check up in these children.