Interdisciplinary evaluation of cerebral hemodynamics in the treatment of arteriovenous fistulae associated with giant varices

Cole A. Giller, H. Hunt Batjer, Phil Purdy, Brandy Walker, Dana Mathews

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

THE TECHNIQUES FOR the treatment of intracranial arteriovenous fistulae include angiographic balloon occlusion of the fistula as well as direct surgical attack. Regardless of the method, the occurrence of severe hyperemia caused by a lack of autoregulation after obliteration of the fistula remains a significant concern. We report the use of single photon emission computed tomography and transcranial Doppler studies to assess the occurrence of hyperemia during trial balloon occlusion of such fistulae in two patients. Single photon emission computed tomography and transcranial Doppler studies confirmed the lack of hyperemia during the test occlusion, allowing consideration of treatment plans involving acute fistula occlusion without the difficulty imposed by gradual occlusion and permitting a more accurate evaluation of risk. The purpose of this report is to illustrate how clinical evaluation of intracranial hemodynamics can contribute significantly to treatment decisions.

Original languageEnglish (US)
Pages (from-to)778-784
Number of pages7
JournalNeurosurgery
Volume35
Issue number4
DOIs
StatePublished - Oct 1994
Externally publishedYes

Keywords

  • Arteriovenous fistulae
  • Balloon occlusion
  • Cerebral blood flow
  • Cerebral fistula
  • Cerebral hemodynamics
  • Transcranial doppler

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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