By Pierre Lasjaunias M.D., Ph.D. (auth.)
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Additional info for Vascular Diseases in Neonates, Infants and Children: Interventional Neuroradiology Management
Sample text
0. : 12 15 I YEARS 24 18 1 3 4 5 I I , 6 ! : PREPAAE CERUL i BRUSH TEETlI. OAESS NO Hap 90 I : PUTONT-sHIIIT 86% NAIlEFlI,1ENDS ! J I < (3 o OAIIK_a. J < Z o In 11: W a.. I i RECIAAD OWN lWfIIII I 1SIlLE I ISPON~ANEPUIL-'I I i I SIlLE i IR~"'Y I=ACrj w > j: a.. < c <, ! OW fasT 3_ I '-i. OW I w~ zl iLl, , ! KICK BAU. FORWARD I WALJ(UPmPS WAU In other situations when the suture en- 28 1 Introduction and General Comments on Intracranial Arteriovenous Diseases largement is too slow or not possible, signs of transependymal resorption become evident. The loss of a functioning resorption gradient is reached, and true hydrocephalic manifestations are observed. Ventricular shunting at that time is associated with significant morbidity (see Fig. 39). This morbidity demonstrates a widespread lack of understanding of the physiology of the water equilibrium in infants and the various and progressive shifts that result in a very unstable situation. In non-Galenic AVM, local congestion rapidly leads to focal ischaemia, as revealed by convulsions and later haemorrhage. Rarely do such infants present with progressive deficit. Post-ischaemic venous haemorrhage infarcts in these PAVM patients are often remote from the AVM site, recurrent and multifocaL In VGAM, pial congestion is absent for a long time and depends on whether maturation of the venous drainage at the skull base occurs (cavernous sinus capture; see Chap. 2). The spontaneous closure of the jugular foramen in VGAM and in some PAVM patients is less likely to be related to a high -flow venous angiopathy, and more likely to maturation.