FLAIR hyperintense vessels on MRI post brain arteriovenous malformation embolization: A novel finding associated with post-procedure intraparenchymal hemorrhage

Introduction Brain arteriovenous malformations (BAVMs) are frequently managed by endovascular embolization with a growing number of centers embolizing with intent to cure. Hemorrhage post-embolization is a severe and poorly understood complication. We present a novel imaging finding associated with...

Full description

Saved in:
Bibliographic Details
Published in:Interventional neuroradiology 2025-02, Vol.31 (1), p.17-23
Main Authors: White, Timothy G, A Shah, Kevin, Fraser, Madison, Turpin, Justin, Teron, Ina, W Link, Thomas, Dehdashti, Amir R, Woo, Henry H
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Cerebral Hemorrhage - diagnostic imaging
Cerebral Hemorrhage - etiology
Cerebral Hemorrhage - therapy
Embolization, Therapeutic - methods
Female
Humans
Intracranial Arteriovenous Malformations - diagnostic imaging
Intracranial Arteriovenous Malformations - therapy
Magnetic Resonance Imaging
Male
Middle Aged
Original s
Retrospective Studies
Treatment Outcome
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction Brain arteriovenous malformations (BAVMs) are frequently managed by endovascular embolization with a growing number of centers embolizing with intent to cure. Hemorrhage post-embolization is a severe and poorly understood complication. We present a novel imaging finding associated with post-embolization hemorrhage that has significantly impacted the management of patients at our institution. Methods A retrospective review of all patients undergoing embolization of BAVM at a single center was performed. Post-embolization magnetic resonance imaging (MRI) was reviewed for the presence of T2 fluid-attenuated inversion recovery (FLAIR) hyperintense vessels (FHVs). Bivariate analysis was performed to determine associations between patient characteristics and risk of hemorrhage. Results A total of 50 patients underwent 75 embolization procedures. Forty-six post-embolization MRIs were available for review. There were four hemorrhages and 100% of those presented with FHV. In contrast, only 11.9% of embolization procedures without post-procedural hemorrhage had FHVs on MRI. In total, 18.7% of embolizations led to some morbidity or mortality, with only 6.7% leading to permanent morbidity or mortality. In bivariate analysis, only the presence of FHVs was correlated with the risk of hemorrhage (p 
ISSN:1591-0199
2385-2011
DOI:10.1177/15910199221146585