Is Intraoperative Ultrasound a Valuable Tool for Brain Arteriovenous Malformation Diagnosis and Treatment? A Case Report.
arteriovenous malformations (avms)
brain avm
cerebrovascular neurosurgery
emergency medicine
intracerebral hemorrhage (ich)
intraoperative ultrasonography
neurosurgery
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
11 Oct 2019
11 Oct 2019
Historique:
entrez:
28
11
2019
pubmed:
28
11
2019
medline:
28
11
2019
Statut:
epublish
Résumé
The localization of arteriovenous malformations (AVMs) intraoperatively in the setting of an acute intracerebral hemorrhage (ICH) is crucial to avoid damage of delicate vascular structures that may even further exacerbate the bleed. Currently, surgical mapping using preoperative angiographic is the standard of practice. We report the use of intraoperative ultrasound for the diagnosis and localization of an AVM in the case of a 61-year-old female with reported iodine contrast allergy and previous severe reaction, in a setting with limited resources, without other imaging options or timely transfer to another facility readily available. Immediate surgical care was warranted to avoid further deterioration of the patient; intraoperative diagnosis and localization of the suspected underlying lesion were done using ultrasound. The ultrasound display showed tubular anechoic intertwined structures that demonstrated bidirectional flow, which is suggestive of an AVM. The intraoperative diagnosis allowed the surgeon to avoid an inadvertent approach to the vascular malformation nidus or vessels, which could have further complicated the case. We believe that intraoperative ultrasound may be valuable for the neurosurgeons today in many settings. Despite the fact that this case occurred in a scenario with limited resources and no other imaging method (such as magnetic resonance imaging (MRI), magnetic resonance angiography (MRA)) available, we advise readers not to rely solely on intraoperative ultrasound.
Identifiants
pubmed: 31772858
doi: 10.7759/cureus.5888
pmc: PMC6839753
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e5888Informations de copyright
Copyright © 2019, Bertani et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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