Cerebellar Arteriovenous Malformation Treatment

see also Posterior Fossa Arteriovenous Malformation Treatment.

In light of the unique natural history and angioarchitectural characteristics of cerebellar arteriovenous malformation, their management is distinct from supratentorial arteriovenous malformation counterparts, requiring a more aggressive treatment strategy.

Emergency microsurgery is effective in the treatment of ruptured cerebellar AVM 1).

Approaches

Occipital transtentorial approach is a valuable approach for specific superior vermian, superomedian cerebellar, and tectal AVMs. Detailed assessment of angiographic features may however preclude its safety as a unique treatment plan, and complementary or alternative therapeutic options should be considered 2) 3).

Gamma knife radiosurgery for arteriovenous malformation

Radiosurgery is an effective treatment modality for Cerebellar Arteriovenous Malformation with relatively limited adverse events. Infratentorial location did not affect radiosurgery outcomes 4). Proved to be most effective for patients with smaller and previously nonembolized cerebellar malformations. Hemorrhage during the latency period occurred at a rate of 2.0% per year until obliteration occurred 5).


1)
Li JP, Zhao QH, Wang Y, Li T, Guo P, Zhao JZ. [Surgical treatment of ruptured cerebellar arteriovenous malformations]. Zhonghua Yi Xue Za Zhi. 2013 Jun 4;93(21):1660-3. Chinese. PubMed PMID: 24125678.
2)
McLaughlin N, Martin NA. The occipital interhemispheric transtentorial approach for superior vermian, superomedian cerebellar, and tectal arteriovenous malformations: advantages, limitations, and alternatives. World Neurosurg. 2014 Sep-Oct;82(3-4):409-16. doi: 10.1016/j.wneu.2013.07.075. Epub 2013 Jul 27. Review. PubMed PMID: 23895929.
3)
Zhao J, Tao Y. The occipital transtentorial approach for cerebellar and midbrain arteriovenous malformation. World Neurosurg. 2014 Sep-Oct;82(3-4):316-7. doi: 10.1016/j.wneu.2013.08.043. Epub 2013 Sep 4. PubMed PMID: 24012552.
4)
Ding D, Starke RM, Yen CP, Sheehan JP. Radiosurgery for cerebellar arteriovenous malformations: does infratentorial location affect outcome? World Neurosurg. 2014 Jul-Aug;82(1-2):e209-17. doi: 10.1016/j.wneu.2014.02.007. Epub 2014 Feb 14. PubMed PMID: 24530455.
5)
Bowden G, Kano H, Tonetti D, Niranjan A, Flickinger J, Lunsford LD. Stereotactic radiosurgery for arteriovenous malformations of the cerebellum. J Neurosurg. 2014 Mar;120(3):583-90. doi: 10.3171/2013.9.JNS131022. Epub 2013 Oct 25. PubMed PMID: 24160482.
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