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Arteriovenous malformations of the posterior fossa: a systematic review

  • Original Article - Vascular Neurosurgery - Arteriovenous malformation
  • Published:
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Abstract

Background

Posterior fossa arteriovenous malformations (pfAVMs) can be challenging lesions to manage. AVMs in this location may have distinct features compared with supratentorial AVMs. Our aim was to systematically review the literature on the presenting characteristics of pfAVMs and compare clinical and angiographic outcomes after the various types of treatment employed.

Methods

The review was conducted according to the Cochrane Collaboration guidelines. Electronic databases from 1900 to March 2018 were searched and complemented by hand-searching and cross-referencing. Articles were categorized into (i) AVM studies that included those in the posterior fossa, (ii) those that focused exclusively on pfAVM, and (iii) those that further specified a cerebellar or brainstem location of the AVM.

Results

Seventy-seven articles with 4512 pfAVM patients were retained for analyses. Compared with historical supratentorial controls, pfAVMs were reported to more frequently present with rupture, to more commonly have associated arterial aneurysms, and to more frequently lead to poor clinical and angiographic outcomes. The quality of the literature and lack of standardization of outcome reporting precluded performing a meta-analysis on the results of the various different treatment modalities.

Conclusions

Posterior fossa AVMs may have some distinct features compared with supratentorial AVMs. The available reports on pfAVMs are not sufficiently standardized to provide reliable guidance for patient management decisions. This goal will require future studies to be multicentric and to focus on standardized, repeatable clinical and angiographic outcomes.

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Abbreviations

AVM:

Arteriovenous malformation

pfAVM:

Posterior fossa AVM

RBAS:

Radiosurgery-based AVM score

mRS:

Modified Rankin scale

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital of Brest, Brest, France

    Elsa Magro & Elyse Denise Okome Mezui

  2. LaTIM, INSERM UMR 1101, Brest, France

    Elsa Magro

  3. Department of Surgery, Division of Neurosurgery, University of Alberta Hospital, Mackenzie Health Sciences Center, Edmonton, Alberta, Canada

    Tim E. Darsaut

  4. Department of Surgery, Service of Neurosurgery, Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada

    Michel W. Bojanowski

  5. Direction de l’Enseignement et de l’Académie CHUM/Bibliothèque, Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada

    Daniela Ziegler

  6. Department of Radiology, Service of Interventional Neuroradiology, University Hospital of Brest, Brest, France

    Jean-Christophe Gentric

  7. GETBO, EA 3878, Brest, France

    Jean-Christophe Gentric

  8. Department of Radiology, Service of Neuroradiology, Centre Hospitalier de l’Université de Montréal (CHUM), room D03.5462b, Montreal, Quebec, H2X 0C1, Canada

    Daniel Roy & Jean Raymond

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  1. Elsa Magro
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All the authors of this manuscript have given substantial contributions to the conception or design of the work, drafting the work and revising it critically for important intellectual content, and final approval of the version to be published.

Corresponding author

Correspondence to Jean Raymond.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

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Magro, E., Darsaut, T.E., Mezui, E.D.O. et al. Arteriovenous malformations of the posterior fossa: a systematic review. Acta Neurochir 162, 905–910 (2020). https://doi.org/10.1007/s00701-020-04260-6

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  • DOI: https://doi.org/10.1007/s00701-020-04260-6

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