Classification of Vascular Malformations
Localization of the AVM Within the Brain
I. Surface Lesions (visible on exploration on the surface of the brain)
II. Deep Lesions (invisible at exploration on the surface)
The Concept of Compartments
Compact and Diffuse Lesions
Sizes, Shapes, and Elements of AVMs
Sizes of AVM
Shape
Pure Fistulous AVM
Elements of an AVM
Arterial Feeders
Venous Drainage
Sinuses
Enlargement, Growth, and Regrowth of AVMs
Enlargement
Growth
Pseudo-Growth
True Growth of the AVM
Spontaneous Thrombosis and Regression of AVMs
Multiple AVMs
Multiple Cerebral AVMs
Intracranial and Intraspinal AVMs
Association of Persistent Trigeminal Artery and AVM
Association of Aneurysm and AVM
Intracranial AVM with Stenosis and Occlusion of Major Vessels
Arterial
Moya-Moya Disease
Venous
AVM Associated with Other Pathological Entities
Tumors
Introduction
Hemodynamics
The Physics of Fluids and Blood Flow
Pressure, Flow, and Resistance
The Nature of Blood
Laminar versus Turbulent Flow
Tortuosity of Vessels
Vascular Distensibility
Cerebral Circulation: Functional Anatomy of the Cerebral Circulation
Neuronal Innervation
Microcirculation
AVM Structure
Enlargement of AVMs
Autoregulation
Normal Perfusion Pressure Breakthrough
Comments on the Normal Perfusion Pressure Breakthrough Theory
Effects of AVMs upon Cerebral Function
Local Mass Effect
Obstruction
Hemorrhage
Vascular Steal
Systemic Effects
Operative Considerations with Regard to Hemodynamics
Preoperative Evaluation
Operative Techniques
Postoperative Care
5 Diagnosis and Follow-up of Patients with Cerebral AVM using Doppler Ultrasound
Herbert M. Keller
6 Neuroradiological Evaluation
A. Valavanis
Computed Tomography
Magnetic Resonance Imaging (MRI)
Cerebral Angiography
Technique
Erroneous Findings
Angiographic Classification
Angiographic Investigation
Limitations of Conventional Selective Angiography
Venous Phase
Associated Aneurysms
Spasm
Summary
7 Microsurgical Anatomy of the Brain
Supratentorial Sulci and Fissures
Fissures
Interhemispheric (Longitudinal) Fissure
Sylvian Fissure
Transverse Fissure
Vascular Patterns Relating to Supratentorial Sulci
Infratentorial Sulci and Fissures
Organization of the Cerebral Microcirculation
The Venous System of the Brain
The Veins of Posterior Fossa
The Collateral Circulation
I Extracranial Arterial Circle
II Dural Arterial Circle
III Basal Cerebral Arterial Circle of Willis
IV Cortical Interhemispherical and Intrahemispherical Arterial Circle
V Cerebellar Arterial Circle