The features of computed tomography and digital subtraction angiography images of ruptured cerebral arteriovenous malformation

Van Tuan Nguyen; Anh Tuan Tran; Nguyen Quyen Le; Thi Huong Nguyen; Van Tuan Nguyen; Anh Tuan Tran; Nguyen Quyen Le; Thi Huong Nguyen

doi:10.3934/medsci.2021011

AIMS Medical Science

2021, Volume 8, Issue 2: 105-115. doi: 10.3934/medsci.2021011

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Research article

The features of computed tomography and digital subtraction angiography images of ruptured cerebral arteriovenous malformation

1.
Neurology department, Bach Mai hospital, Ha Noi, Vietnam
2.
Radiology center, Bach Mai hospital, Ha Noi, Vietnam
3.
Radiology department, Ha Noi Medical University, Ha Noi, Vietnam
4.
Department of Thoracic, Vascular and Neurology, Trung Vuong Hospital, Ho Chi Minh city, Vietnam
5.
General internal medicine department, Vinmec International hospital, Ha Noi, Vietnam
† These two authors contributed equally.

Received: 14 February 2021 Accepted: 07 April 2021 Published: 19 April 2021

Objectives
This study aims to analyze lesions on computed tomography (CT) images and digital subtraction angiography (DSA) of ruptured cerebral arteriovenous malformation (AVM).

Methods
Cross-sectional description of 82 patients' cerebral bleeding due to rupture of AVM, determined by multislice computed tomography or cerebral DSA at Bach Mai Hospital.

Results
Patients with ruptured AVM are commonly under 40 years old (62.2%), average age: 35.1 ± 11.2. On CT or DSA images, it is common to see AVM rupture causing cerebral bleeding in the supratentorial region (91.5%), with 83% cerebral lobe bleeding, mainly small and moderate hematoma volume (<60 cm³) (74.4%), and a low rate of consciousness disorders (p < 0.05). AVM is usually found in the supratentorial region (91.5%), and the size is small (74.4%) (p < 0.05). The feeding arteries are mainly derived from the middle (53.7%) and posterior (42.7%) cerebral arteries; 70.7% is drained by superficial veins. According to the Spetzler–Martin classification, degrees I and II account for the highest percentage (73.2%), in which the majority of patients are selected for surgery; grades IV and V have a low rate (8.5%), often a combination of vascular and surgical nodes.

Conclusions
On MSCT and DSA images, ruptured AVMs often cause lobar hemorrhage in young people. AVMs are usually small to moderate in size. The feeding arteries are mainly derived from middle and posterior cerebral arteries, and drained mainly by superficial veins. The Spetzler–Martin classification and the supplementary grading scales are used for ranking the severity of the lesion, as well as for choosing AVM treatment options and assessing the prognosis.
- rupture,
- arteriovenous malformation,
- computed tomography,
- digital subtraction angiography,
- Spetzler–Martin classification
Citation: Van Tuan Nguyen, Anh Tuan Tran, Nguyen Quyen Le, Thi Huong Nguyen. The features of computed tomography and digital subtraction angiography images of ruptured cerebral arteriovenous malformation[J]. AIMS Medical Science, 2021, 8(2): 105-115. doi: 10.3934/medsci.2021011

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Abstract

Objectives

This study aims to analyze lesions on computed tomography (CT) images and digital subtraction angiography (DSA) of ruptured cerebral arteriovenous malformation (AVM).

Methods

Cross-sectional description of 82 patients' cerebral bleeding due to rupture of AVM, determined by multislice computed tomography or cerebral DSA at Bach Mai Hospital.

Results

Patients with ruptured AVM are commonly under 40 years old (62.2%), average age: 35.1 ± 11.2. On CT or DSA images, it is common to see AVM rupture causing cerebral bleeding in the supratentorial region (91.5%), with 83% cerebral lobe bleeding, mainly small and moderate hematoma volume (<60 cm³) (74.4%), and a low rate of consciousness disorders (p < 0.05). AVM is usually found in the supratentorial region (91.5%), and the size is small (74.4%) (p < 0.05). The feeding arteries are mainly derived from the middle (53.7%) and posterior (42.7%) cerebral arteries; 70.7% is drained by superficial veins. According to the Spetzler–Martin classification, degrees I and II account for the highest percentage (73.2%), in which the majority of patients are selected for surgery; grades IV and V have a low rate (8.5%), often a combination of vascular and surgical nodes.

Conclusions

On MSCT and DSA images, ruptured AVMs often cause lobar hemorrhage in young people. AVMs are usually small to moderate in size. The feeding arteries are mainly derived from middle and posterior cerebral arteries, and drained mainly by superficial veins. The Spetzler–Martin classification and the supplementary grading scales are used for ranking the severity of the lesion, as well as for choosing AVM treatment options and assessing the prognosis.

Conflicts of interest

The authors declare no conflict of interest.

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