Rolandic arteriovenous malformations: improvement in limb function by IBC embolization

Three patients with arteriovenous malformations in the rolandic region and significant limb deficit showed virtually complete functional recovery after awake operative embolization of most of the malformations using isobutyl-2 cyanoacrylate. Two of these patients, with functionally useless hands, ha...

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Bibliographic Details
Published in:American journal of neuroradiology : AJNR 1985-07, Vol.6 (4), p.575-582
Main Authors: Fox, AJ, Girvin, JP, Vinuela, F, Drake, CG
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Bucrylate
Case Reports
Cerebral Angiography
Cyanoacrylates
Embolization, Therapeutic
Extremities - physiopathology
Female
Humans
Intracranial Arteriovenous Malformations - complications
Intracranial Arteriovenous Malformations - diagnostic imaging
Intracranial Arteriovenous Malformations - therapy
Male
Medical sciences
Neurology
Paralysis - etiology
Vascular diseases and vascular malformations of the nervous system
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Summary:Three patients with arteriovenous malformations in the rolandic region and significant limb deficit showed virtually complete functional recovery after awake operative embolization of most of the malformations using isobutyl-2 cyanoacrylate. Two of these patients, with functionally useless hands, had sustained the deficits months earlier as the result of a specific brain-damaging event: one as a result of surgery and the other as a result of a hemorrhage. Both of these showed significant return of function during the awake operative embolization procedure. The other patient had had progressive leg weakness over a 2 year period. The theory of steal phenomenon as an explanation for progressive neurologic deficits in association with large arteriovenous malformations must be extended to explain apparently stable deficits after some brain trauma (surgery or hemorrhage). These results suggest that some patients with arteriovenous malformations and without clinical deficits who are near a critical level of "near ischemia" may be thrown out of balance by an acute interceding event.
ISSN:0195-6108
1936-959X