Abstract
Angiographically confirmed surgical resection is believed to be the ‘gold standard’ for cure in the treatment of intracranial arteriovenous malformations (AVMs). However, rare exceptions of recurrent AVMs have been documented. We are aware of 11 reported cases of recurrent AVMs in which complete resection of the initial lesion was confirmed by postoperative angiography. Eight of these cases were in the pediatric population. In this report, we present 2 additional cases of such recurrent lesions, review the clinical and scientific literature on this rare phenomenon and provide suggested management guidelines.
References
1.
Rothbart D, Awad IA, Lee J, Kim J, Harbaugh R, Criscuolo GR: Expression of angiogenic factors and structural proteins in central nervous system vascular malformations. Neurosurgery 1996;38:915–924.
2.
Stein BM, Wolpert SM: Arteriovenous malformations of the brain. I. Current concepts and treatment. Arch Neurol 1980;37:1–5.
3.
Crawford PM, West CR, Chadwick DW, Shaw MDM: Arteriovenous malformations of the brain: Natural history in unoperated patients. J Neurol Neurosurg Psychiatry 1986;49:1–10.
4.
Ondra SO, Troupp H, George ED, Schwab K: The natural history of symptomatic arteriovenous malformations of the brain: A 24-year follow-up assessment. J Neurosurg 1990;73:387–391.
5.
Michelson WJ: Arteriovenous malformations of the brain and spinal cord. Curr Ther Neurol Dis 1987;2:170–172.
6.
Stein BM, Kader A: Intracranial arteriovenous malformations. Clin Neurosurg 1992;39:76–113.
7.
Kader A, Goodrich JT, Sonstein WJ, Stein BM, Carmel PW, Michelson WJ: Recurrent cerebral arteriovenous malformations after negative postoperative angiograms. J Neurosurg 1996;85:14–18.
8.
Kondziolka D, Humphreys RP, Hoffman HJ, Hendrick EB, Drake JM: Arteriovenous malformations of the brain in children: A forty-year experience. Can J Neurol Sci 1992;19:40–45.
9.
Yasargil MG: Microneurosurgery. New York, Thieme, 1988, vol IIIB, pp 376–379.
10.
Santoro A, Giuliani S, Paolini S: Recurrent arteriovenous malformations in an adult. J Neurosurg 2000;93:1082.
11.
Hino A, Fujimoto M, Iwamoto Y, Takahashi Y, Katsumori T: An adult case of recurrent arteriovenous malformation after ‘complete’ surgical excision: A case report. Surg Neurol 1999;52:156–159.
12.
Gabriel EM, Sampson JH, Wilkins RH: Recurrence of a cerebral arteriovenous malformation after surgical excision. J Neurosurg 1996;84:879–882.
13.
Amacher AL, Allock JM, Drake CG: Cerebral angiomas: The sequelae of surgical treatment. J Neurosurg 1972;37:571–575.
14.
Davis C, Symon L: The management of cerebral arteriovenous malformations. Act Neurochir 1985;74:4–11.
15.
Drake CG: Cerebral arteriovenous malformations: Consideration for and experience with surgical treatment in 166 cases. Clin Neurosurg 1979;26:145–208.
16.
Jomin M, Lesoin F, Lozes G: Prognosis for arteriovenous malformations of the brain in adults based on 150 cases. Surg Neurol 1985;23:362–366.
17.
Nornes H, Lundar T, Wikeby P: Cerebral arteriovenous malformations: Results of microsurgical management. Acta Neurochir 1979;50:243–257.
18.
Wilson CB, Hoi Sang U, Domingue J: Microsurgical treatment of intracranial vascular malformations. J Neurosurg 1979;51:446–454.
19.
Hofmeister C, Stapf C, Hartmann A, Sciacca RR, Mansemann U, ter Brugge K, Lasjaunias P, Mohr JP, Mast H, Meisel J: Demographic, morphological, and clinical characteristics of 1,289 patients with brain arteriovenous malformation. Stroke 2000;31:1307–1310.
20.
Koizumi T, Shiraishi T, Hagihara N, Tabuchi K, Hayashi T, Kawano T: Expression of vascular endothelial growth factors and their receptors in and around intracranial arteriovenous malformations. Neurosurgery 2002;50:117–126.
21.
Sure U, Butz N, Siegel AM, Mennel HD, Bien S, Bertalanffy H: Treatment-induced neoangiogenesis in cerebral arteriovenous malformations. Clin Neurol Neurosurg 2001;103:29–32.
22.
Fuse T, Niwa Y, Umezu M, Yamada K: Growth of occult arteriovenous malformation after cerebral hemorrhage demonstrated by serial magnetic resonance imaging. Neurol Med Chir (Tokyo) 2001;41:83–86.
23.
Abdulrauf SI, Malik GM, Awad IA: Spontaneous angiographic obliteration of cerebral arteriovenous malformations. Neurosurgery 1999;44:280–288.
24.
Schmit BP, Burrows PE, Kuban K, Goumnerova L, Scott RM: Acquired cerebral arteriovenous malformation in a child with moyamoya disease. J Neurosurg 1996;84:677–680.
25.
Folkman J, Klagsbrun M: Angiogenic factors. Science 1987;235:442–447.
26.
Chen HH, Chien CH, Liu HM: Correlation between angiogenesis and basic fibroblast growth factor expression in experimental brain infarct. Stroke 1994;25:1651–1657.
27.
Sonstein WJ, Kader A, Michelsen WJ, Llena JF, Hirano A, Casper D: Expression of vascular endothelial growth factor in pediatric and adult cerebral arteriovenous malformations: An immunocytochemical study. J Neurosurg 1996;85:838–845.
28.
Sheikh BY, Hassounah M, Al-Moutare K, Ammar A, Enazi A: Childhood intracranial arteriovenous malformation in Saudi Arabia. Childs Nerv Syst 1999;15:262–266.
© 2003 S. Karger AG, Basel
2003
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