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Academia Mexicana de Neurología, A.C.

2006, Number 6

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Rev Mex Neuroci 2006; 7 (6)

Neuropsychological profile of patients with arteriovenous malformations

Díaz-Victoria AR, Idrovo Velandia-Álvaro J

Language: Spanish
References: 35
Page: 550-557
PDF size: 91.75 Kb.


ABSTRACT

Introduction: Arteriovenous malformations (AVM’s) of the brain are congenital lesions characterized by abnormal communications between arteries and veins; they are formed at three weeks of gestation. Later, additional arterial contributions are acquired, and size and number increase significantly. There is few evidence about effects of this pathology in psychological processes, and most of the literature describes isolated symptoms, without a difference between patients with and without hemorrhage. Single cases analyzed with functional neuroimagery are frequently more detailed. Objective: To describe neuropsychological features in patients with a single AVM. Patients and methods: 27 patients with a non-bleed AVM are shown. They are assessed with a wide neuropsychological test (“Test Barcelona”) and data are analyzed. Results: In quantitative analysis, most of the patients (n = 21) showed symptomatology directly related with localization of AVM and adjacent areas (p = 0.007), five patients showed symptoms related with other cerebral areas (ipsilateral and contralateral structures) and only one patient was totally asymptomatic. Qualitatively, 26 patients showed obvious impairments, since 6 to 35 altered subtests. Neuropsychological clinic characteristics include slow processing, need of frequent facilitations and impossibility to do the task. Conclusions: Regular neuropsychological symptoms in patients with AVM are suggested. “Steal phenomenon” plays an essential role in such manifestations. Impairment is not severe, but is present in most of the cases. Neuropsychological analysis is very important to explain these data.


REFERENCES

  1. Adams R, Victor M, Ropper A. Principles of neurology. USA: McGraw Hill. International Edition; 1997.

  2. Stein BM, Wolpert SM. Arteriovenous malformations of the brain. I: Current Concepts and Treatment. Arch Neurol 1980; 37(1): 1-5.

  3. Nornes H, Grip A. Hemodynamic aspects of cerebral arteriovenous malformations. J Neurosurg 1980; 53: 456-64.

  4. Deutsch G. Blood flow changes in arteriovenous malformation during behavioural activation. Ann Neurol 1983; 13: 38-43.

  5. Fernández-Melo R, López-Flores G, Cruz- García O, Jordán-González J, Felipe-Morán A, Benavides-Barbosa J, et al. Diagnóstico de las malformaciones arteriovenosas cerebrales. Rev Neurol 2003; 37(9): 870-8.

  6. Waltimo O, Putkonen AR. Intellectual performance of patients with intracranial arteriovenous malformations. Brain 1974; 7: 511-20.

  7. McKenzie I. The clinical presentation of the cerebral angioma. A review of 50 cases. Brain 1953; 76: 184-214.

  8. Paterson JH, McKissock W. A clinical survey of intracranial angiomas with special reference to their mode of progression and surgical treatment: a report of 110 cases. Brain 1956; 79: 233-66.

  9. Pool JL. Treatment of arteriovenous malformations of the cerebral hemispheres. J Neurosurg 1962; 19: 136-41.

  10. Svien HJ, McRae JA. Arteriovenous anomalies of the brain. Fate of patients not having definitive surgery. J Neurosurg 1965; 23: 23-8.

  11. Moody RA, Poppen JL. Arteriovenous malformations. J Neurosurg 1970; 32: 503-11.

  12. Andersen EB, Petersen J, Mortensen EL, Udessen H. Conservatively treated patients with cerebral arteriovenous malformation: mental and physical outcome. J Neurol Neurosurg Psychiatry 1988; 51: 1208-12.

  13. Gómez-Tortosa E, Martin EM, Gaviria M, Charbel F, Ausman JI. Selective deficit of one language in a bilingual patient following surgery in the left perisylvian aerea. Brain Lang 1995; 48: 320-5.

  14. Conley FK, Moses JA, Helle TL. Deficits of higher cortical functioning in two patients with posterior parietal arteriovenous malformations. Use of the standardized Luria-Nebraska neuropsychological battery for pre- and postoperative assessment. Neurosurgery 1980; 7(3): 230-7.

  15. Overbeeke JJv, Bosma NJ, Verdonck AF, Huffelen ACv. Higher cortical disorders: an unusual presentation of an arteriovenous malformation. Neurosurgery 1987; 21(6): 839-42.

  16. Jaillard AS, Peres B, Hommel M. Neuropsychological features of dementia due to dural arteriovenous malformation. Cerebrovasc Dis 1999; 9: 91-7.

  17. Maldjian MD, Atlas SW, Howard RS, Greenstein E, Alsop D, Detre JA, et al. Functional magnetic resonance imaging of regional brain activity in patients with intracerebral arteriovenous malformations before surgical or endovascular therapy. J Neurosurg 1996; 84: 477-83.

  18. Sugita M, Takahashi A, Ogawa A, Yoshimoto T. Improvement of cerebral blood flow and clinical symptoms associated with embolization of a large arteriovenous malformation: Case report. Neurosurgery 1993; 33: 748-52.

  19. Peña-Casanova J. Programa integrado de exploración neuropsicológica “Test Barcelona”. Barcelona: Masson; 1991.

  20. Tsvetkova LS. Reeducación del lenguaje, la lectura y la escritura. Barcelona: Fontanela; 1983.

  21. Close RA, O’Keefe MA, Buchheit WA. The determination of speech organization in a patient with an arteriovenous malformation. Neurosurgery 1977; 1(2): 111-13.

  22. Lazar RM, Marshall RS, Pile-Spellman J, Hacein-Bey L, Young WL, Mohr JP, Stein BM. Anterior translocation of language in patients with left cerebral arteriovenous malformation. Neurology 1997; 49: 802-8.

  23. Lazar RM, Marshall RS, Pile-Spellman J, Duong HC, Mohr JP, Young WL, Solomon RL, Perera GM, DeLaPaz RL. Interhemispheric transfer of language in patients with left frontal cerebral arteriovenous malformation. Neuropsychologia 2000; 38: 1325-32.

  24. Mahalick DM, Ruff RM, Sang H. Neuropsychological sequelae of arteriovenous malformation. Neurosurgery 1991; 29: 351-7.

  25. Martin NA, Beatty J, Johnson RA, Collaer ML, Viñuela F, Becker DP, et al. Magnetoencephalographic localization of a language processing cortical area adjacent to a cerebral arteriovenous malformation. J Neurosurg 1993; 79: 584-8.

  26. Scholosser MJ, McCarthy G, Fulbright RK, Gore JC, Awad IA. Cerebral vascular malformations adjacent to sensoriomotor and visual cortex. Functional magnetic resonance imaging studies before and after therapeutic intervention. Stroke 1997; 28: 1130-7.

  27. Alkadhi H, Kollias SS, Crelier GR, Golay X, Hepp-Reymond MC, Valavanis A. Plasticity of the human motor cortex in patients with arteriovenous malformations: a functional MR imaging study. AJNR Am J Neuroradiol 2000; 21: 1423-33.

  28. Lehéricy S, Biondi A, Sourour N, Vlaicu M, Tézenas du Montcel S, Cohen L, et al. Arteriovenous brain malformations: Is functional MR imaging reliable for studying language reorganization in patients? Initial observations. Radiology 2002; 223: 672-82.

  29. Luria AR. Mirando hacia atrás. Madrid: Norma; 1979.

  30. Luria, AR. Las funciones corticales superiores en el hombre. México: Fontamara; 1986.

  31. Vygotski LS. El desarrollo de los procesos psicológicos superiores. México: Grijalbo; 1988.

  32. Estupiñán B, López G, Morales L, Ochoa L, García I, Guerra E, et al. Enfoque multidisciplinario en el manejo de las malformaciones vasculares cerebrales. Rev Neurol 1999; 29(11): 1013-17.

  33. Pietilä T, Höll T, Schilling A, Kömbos T, Stendel R, Oltmanns F, et al. The 1997 Berlin strategy for the surgical treatment of the brain AVMs in eloquent areas: Significant improvement of postoperative outcome. Clin Neurol Neurosurg 1997; 99(S1): S125.

  34. Lazar R. Neuropsychological function and brain arteriovenous malformations: redefining eloquence as a risk for treatment. Neurosurg Focus 2001; 11(5): 1-4.

  35. Marshall GA, Jonker B, Morgan M, Taylor A. Prospective study of neuropsychological and psychosocial outcome following surgical excision of intracerebral arteriovenous malformations. J Clin Neurosci 2003; 10(1): 42-7.




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