Intracranial vascular malformations, and

Knaut, M. (2006) Intracranial vascular malformations and aneurysms from diagnostic work-up to endovascular therapy. Springer. 

Intracranial Vascular Malformations and Aneurysms From Diagnostic Work-Up to Endovascular Therapy Edited by M. Forsting... 

The editors focus on intracranial vascular malformations and aneurysms which, together, comprise a major proportion of the bread earned by the neurointerventional-ist. The book not only deals excellently with interventional procedures, but also illuminates underlying pathological changes, different classification schemes, indications for endovascular therapy and relevant studies that have been conducted in this field. 

I am convinced that the second edition of Intracranial Vascular Malformations and Aneurysms will be at least as successful as the first one. 

Primary intracerebral hemorrhage is more common than subarachnoid hemorrhage, and its incidence increases with age (see Fig. 1.1). It is more frequent in Southeast Asian, Japanese and Chinese populations than in whites. The most common causes are intracranial small vessel disease, which is associated with hypertension, cerebral amyloid angiopathy and intracranial vascular malformations (Sutherland and Auer 2006). Rarer causes include saccular aneurysms, hemostatic defects, particularly those induced by anticoagulation or therapeutic thrombolysis, antiplatelet drugs, infective endocarditis, cerebral vasculitis and recreational drug use (Neiman et al. 2000 O Connor et al. 2005). 

Intracranial vascular malformations are uncommon, probably congenital, and sometimes familial (Byrne 2005). Those in the dura, draining into the sinuses rather than cerebral veins, can also be caused by skull fracture, craniotomy or dural sinus thrombosis. The overall intracranial vascular malformations detection rate is approximately 3 per 100 000 population per annum and the prevalence is about 20 per 100 000 (Brown et al. 1996). 

Bornebroek M, Westemdorp RGJ, Haan J et al. (1997). Mortality from hereditary cerebral haemorrhage with amyloidosis Dutch type. The impact of sex parental transmission and year of birth. Brain 120 2243-2249 Brott T, Broderick J, Kothari R et al. (1997). Early haemorrhage growth in patients with intracerebral haemorrhage. Stroke 28 1-5 Brown RD, Wiebers DO, Torner JC et al. (1996). Incidence and prevalence of intracranial vascular malformations in Olmsted, County Minnesota 1965 to 1992. Neurology 46 949-952... 

The main clinical indications for imaging the cerebral circulation are TIA (e.g. to identify arterial stenosis), acute ischemic stroke (e.g. to identify vessel occlusion), intracerebral hemorrhage (e.g. to identify an underlying vascular malformation) and possible arterial dissection, flbromuscular dysplasia or other arteriopathies, cerebral aneurysm, intracranial venous thrombosis or cerebral vasculitis. 

Brown RD Jr, Wiebers DO, Torner JC et al. (1996b) Frequency of intracranial hemorrhage as a presenting symtom and subtype analysis a population-based study of intracranial vascular malformations in Olmsted Country, Minnesota. J Neurosurg 85 29-32... 

Intracranial aneurysms do not fall precisely into the category of true vascular malformations they are usually acquired. However, we included them because any neuroradiologist with an interest in vascular malformations and/or endovascular therapy clearly expects this entity to be covered extensively... 

Noran, H.H., 1945. Intracranial vascular tumors and malformations. Archives of Pathology 39, 393 16. 

Less frequently, mucosal hyperemia can occur in women during the premenstrual period (Fig. 20.2). EPX in those cases is usually modest and does not require therapy most of the time. Intracranial vascular malformations draining towards the cavernous sinus and secondarily through orbital veins may give rise to EPX treatment of these malformations relieves the bleedings thanks to the secondary venous decongestion. 

The hematoma continues to expand after stroke onset, frequently causing further deterioration (Brott et al. 1997 Leira et al. 2004). Some brainstem hemorrhages evolve subacutely, particularly those caused by a vascular malformation (O Laoire et al. 1982 Howard 1986). Any large hematoma may cause brain shift, transtentorial herniation, brainstem compression and raised intracranial pressure. Hematomas in the posterior fossa are particularly likely to cause obstructive hydrocephalus. Rupture into the ventricles or on to the surface of the brain is common, causing blood to appear in the subarachnoid space. 

Abstract This chapter focuses on the vascular applications of injectable biomatetials. Two clinically relevant vascular conditions, cerebral arteriovenous malformations and intracranial aneurysm, will be discussed in terms of endovascular embolization. This chapter then outlines available embolic materials used to treat each condition, as well as highlighting new injectable biomaterials developed for embolization purposes. 

---