Multimodal management in cerebral arteriovenous malformations associated with multiple aneurysms. Case report and literature review

Abstract

The pathogenesis of intracranial aneurysms associated with arteriovenous malformations is not well understood and is still under discussion; The development of these lesions may be related to the presence of hemodynamic factors created by the presence of the arteriovenous shunt, for this reason, most aneurysms are proximal to the arteries afferent to the malformation. Endovascular embolization by stages in large cerebral arteriovenous malformations is often performed to gradually reduce flow and prevent abrupt hemodynamic changes. Aneurysms of the alimentary artery have been associated with an increased risk of hemorrhage, that’s why decisions about when and how to treat intracranial aneurysms of these characteristics have always been a therapeutic challenge for both, vascular and endovascular neurosurgeons. In the present manuscript, we report the case of a 51-year-old patient with multiple aneurysms associated with arteriovenous malformation, as well as her neurosurgical management, with a comparative analysis what has been published in the medical and scientific literature in the last 20 years. a comprehensive review on various platforms and databases such as PUBMED, NCBI, Medline and Ovid.