By H. W. Pia (auth.), H. W. Pia, J. R. W. Gleave, E. Grote, J. Zierski (eds.)
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Extra info for Cerebral Angiomas: Advances in Diagnosis and Therapy
Six convexity AVMs were considered inoperable because of their size; another 5 were situated over the medial aspect of the parietal lobes, involving both hemispheres and the corpus callosum in 3. The blood supply to these malformations came from 2 main arteries in 15 cases, 3 arteries in 5, 4 arteries in 6, and in one case the arterial supply could not be fully identified, because the malformation covered the medulla oblongata and the cervical cord. One or both posterior cerebral arteries were frequently involved together with the anterior choroidal and peri-callosal arteries.
The third group contains diffuse angiomas with numerous, enlarged draining veins, some of which are well developed far away from the angioma and not infrequently have the appearance of typical venous dilatations. Especially in the late capillary or late venous 31 phases, one gains the impression of a cerebral "varicosis", if you will allow the use of this term here. In the fourth group we include the previously discussed, so-called aneurysms of the great vein of Galen. As we said at the beginning, these angiomas may probably best be grouped more or less with the venous angiomas.
The demand for adequate angiographic diagnosis is frequently met today by rapid serial angiography. A good and adequate demonstration of all the arteries participating in the cerebral circulatory system must be regarded as the basic requirement. Thus, a widespread use of the vertebral angiogram has revealed even in case of vascular malformations in the supratentorial area that the branches of the posterior cerebral artery are involved to a greater or less high degree in the blood supply of these angiomas, which are supplied in the main from the carotid system, and may in individual cases constitute the sole source of supply.