医学教学课件：脑动静脉畸形
合集下载
相关主题
- 1、下载文档前请自行甄别文档内容的完整性，平台不提供额外的编辑、内容补充、找答案等附加服务。
- 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
- 3、如文档侵犯您的权益，请联系客服反馈,我们会尽快为您处理(人工客服工作时间：9:00-18:30)。
Fra Baidu bibliotek
vessels change with
time
may develop aneurysms
Pathology & Pathophysiology
absence of normal parenchymal changes
capillary system
within and around the
usual function displaced lesion
Seventh gestational week vessels sprout branches & penetrate developing brain reach the gray-white interface, either loop back to pial surface or traverse entire neural tube, thus epicerebral & transcerebral circ'n eventually connect arterial and venous systems by around the twelfth week
factors contributing to symptoms
– vessel walls, flow and pressures – enlargement and encroachment – dural sinuses – ischaemia
Pathology & Pathophysiology
absence of normal parenchymal changes
capillary system
within and around the
usual function displaced lesion
asymptomatic at birth
Embryology
First half of third week of gestation epiblastic cells migrate to form mesoderm mesodermal cells differentaite to arterial and venous vessel on the surface of the embryonic nervous system
Embryology
First half of third week of gestation epiblastic cells migrate to form mesoderm mesodermal cells differentiate to arterial and venous vessels on the surface of the embryonic nervous system
– high output failure, neonate, vein of Galen – hydrocephalus, first decade – headache, hemorrhage, seizures, 2nd & 3rd
Clinical presentation
factors contributing to symptoms
Clinical presentation
factors contributing to symptoms
– vessel walls, flow and pressures – enlargement and encroachment – dural sinuses
Clinical presentation
Clinical presentation
95% have symptoms by age of 70 years peak presentation second to fourth decade
Clinical presentation
95% have symptoms by age of 70 years peak presentation second to fourth decade
Pathology & Pathophysiology
absence of normal capillary system
Pathology & Pathophysiology
absence of normal capillary system usual function displaced
Pathology & Pathophysiology
– vessel walls, flow and pressures
Clinical presentation
factors contributing to symptoms
– vessel walls, flow and pressures – enlargement and encroachment
asymptomatic at birth site frequency is
vessels change with proportional to brain
time
volume
may develop aneurysms
Clinical presentation
95% have symptoms by age of 70 years
absence of normal capillary system usual function displaced asymptomatic at birth
Pathology & Pathophysiology
absence of normal capillary system usual function displaced asymptomatic at birth vessels change with time may develop aneurysms
AVM: a TLA for the CNS
CEREBRAL ARTERIOVENOUS MALFORMATIONS
Incidence
0.52% at autopsy Slight male preponderance (1.09 to 1.94) Congenital lesions (although rarely familial)
vessels change with
time
may develop aneurysms
Pathology & Pathophysiology
absence of normal parenchymal changes
capillary system
within and around the
usual function displaced lesion
Seventh gestational week vessels sprout branches & penetrate developing brain reach the gray-white interface, either loop back to pial surface or traverse entire neural tube, thus epicerebral & transcerebral circ'n eventually connect arterial and venous systems by around the twelfth week
factors contributing to symptoms
– vessel walls, flow and pressures – enlargement and encroachment – dural sinuses – ischaemia
Pathology & Pathophysiology
absence of normal parenchymal changes
capillary system
within and around the
usual function displaced lesion
asymptomatic at birth
Embryology
First half of third week of gestation epiblastic cells migrate to form mesoderm mesodermal cells differentaite to arterial and venous vessel on the surface of the embryonic nervous system
Embryology
First half of third week of gestation epiblastic cells migrate to form mesoderm mesodermal cells differentiate to arterial and venous vessels on the surface of the embryonic nervous system
– high output failure, neonate, vein of Galen – hydrocephalus, first decade – headache, hemorrhage, seizures, 2nd & 3rd
Clinical presentation
factors contributing to symptoms
Clinical presentation
factors contributing to symptoms
– vessel walls, flow and pressures – enlargement and encroachment – dural sinuses
Clinical presentation
Clinical presentation
95% have symptoms by age of 70 years peak presentation second to fourth decade
Clinical presentation
95% have symptoms by age of 70 years peak presentation second to fourth decade
Pathology & Pathophysiology
absence of normal capillary system
Pathology & Pathophysiology
absence of normal capillary system usual function displaced
Pathology & Pathophysiology
– vessel walls, flow and pressures
Clinical presentation
factors contributing to symptoms
– vessel walls, flow and pressures – enlargement and encroachment
asymptomatic at birth site frequency is
vessels change with proportional to brain
time
volume
may develop aneurysms
Clinical presentation
95% have symptoms by age of 70 years
absence of normal capillary system usual function displaced asymptomatic at birth
Pathology & Pathophysiology
absence of normal capillary system usual function displaced asymptomatic at birth vessels change with time may develop aneurysms
AVM: a TLA for the CNS
CEREBRAL ARTERIOVENOUS MALFORMATIONS
Incidence
0.52% at autopsy Slight male preponderance (1.09 to 1.94) Congenital lesions (although rarely familial)