Feeding artery aneurysm

Arteriovenous malformations present most commonly with signs consistent with a space-occupying lesion or seizures and consist of an abnormal fistulous connection(s) between one or more hypertrophied feeding arteries and dilated draining veins (Clatterbuck et al. 2005) (Fig. 7.5). The blood supply is derived from one cerebral artery or, more often, several, sometimes with a contribution from branches of the external carotid artery. Arteriovenous malformations vary from a few millimeters to several centimeters in diameter. Approximately 15% are associated with aneurysms on their feeding arteries. Some grow during life but a few shrink or even disappear, and some are multiple. These fistulae occur in or on the brain, or in the dura of the intracranial sinuses. 

Fig. 17.2a,b. PAVM diagnosed using CT with multiplanar reconstructions. CT obtained in axial view (a) and coronal maximum intensity projection view (b) shows a single PAVM of the left lower lobe. The feeding artery, aneurysmal sac and draining vein are easily identified... 

In some instances, complete cure is deemed impossible despite a combined technique. Partial treatment can yet be indicated in some cases (a) to cure a weak point of the AVM such as a false aneurysm, intranidal aneurysms, or large feeding artery aneurysms (Fig. 3.6) (b) to improve the clinical symptoms in case of a large AVM presenting with progressive neurologic deficits (Fox 1997). 

Partially targeted treatment (embolization) to eliminate risk factors of hleeding/rehleeding (feeding artery aneurysms, intranidal aneurysms, false aneurysms)... 

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