Document Detail


Staged surgery for a large cerebral arteriovenous malformation to prevent the overload phenomenon.
MedLine Citation:
PMID:  18639109     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Intracerebral hemorrhage and/or edema is a sequel following removal of a large nidus. We call the vascular load an 'overload phenomenon'. To prevent it by stepwise reduction of the nidus size, staged surgery is recommended for a large AVM (nidus size of more than 5 cm). With the recent advancement of the intravascular technique, preoperative embolization is also a good option to reduce the nidus size resulting in a prevention of the overload phenomenon and a reduction in intraoperative bleeding. The overload phenomenon is visualized on the immediate postoperative angiogram as 'modja-modja' (stagnating and shaggy) vessels around the removed nidus, which disappear in a month. We present a case in which those vessels were identified. Maintaining the postoperative blood pressure at 80 to 100 mmHg is also essential for preventing the overload phenomenon prior to staged surgery and/or preoperative embolization.
Authors:
K Hongo; S Kobayashi; T Takemae; H Nakagawa; S Mabuchi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia     Volume:  5 Suppl     ISSN:  0967-5868     ISO Abbreviation:  J Clin Neurosci     Publication Date:  1998 Mar 
Date Detail:
Created Date:  2008-07-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9433352     Medline TA:  J Clin Neurosci     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  84-6     Citation Subset:  -    
Affiliation:
Department of Neurological Surgery, Aichi Medical University, Aichi, Japan.
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