BACKGROUND: A patient with normal perfusion pressure breakthrough (NPPB) after surgical removal of an arteriovenous malformation (AVM) was evaluated using single photon emission computed tomography cerebral blood flow (CBF) imaging. CASE DESCRIPTION: A 48-year-old man suffered consciousness disturbance because of an intraventricular hemorrhage and underwent ventricular drainage. Cerebral angiography showed a medium-sized AVM in the left parietal lobe. Three months after the ictus, a left parietal craniotomy was performed and total removal of the AVM was achieved. A brain region adjacent to the AVM with preoperative decreased vasoreactivity to acetazolamide showed marked hyperperfusion after AVM excision. Hemorrhage subsequently occurred in this area. CONCLUSION: CBF mapping seems to offer a noninvasive method for the preoperative identification of AVM patients at risk for NPPB, and to allow for early postoperative diagnosis of NPPB.
BACKGROUND: A patient with normal perfusion pressure breakthrough (NPPB) after surgical removal of an arteriovenous malformation (AVM) was evaluated using single photon emission computed tomography cerebral blood flow (CBF) imaging. CASE DESCRIPTION: A 48-year-old man suffered consciousness disturbance because of an intraventricular hemorrhage and underwent ventricular drainage. Cerebral angiography showed a medium-sized AVM in the left parietal lobe. Three months after the ictus, a left parietal craniotomy was performed and total removal of the AVM was achieved. A brain region adjacent to the AVM with preoperative decreased vasoreactivity to acetazolamide showed marked hyperperfusion after AVM excision. Hemorrhage subsequently occurred in this area. CONCLUSION: CBF mapping seems to offer a noninvasive method for the preoperative identification of AVM patients at risk for NPPB, and to allow for early postoperative diagnosis of NPPB.
Authors: C Wu; S A Ansari; A R Honarmand; P Vakil; M C Hurley; B R Bendok; J Carr; T J Carroll; M Markl Journal: AJNR Am J Neuroradiol Date: 2015-02-26 Impact factor: 3.825