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Master Thesis

Malformations arterio-veineuses thalamiques : modes de présentation clinique, angio-architecture et prise en charge thérapeutique

Abstract : To evaluate prevalence of thalamic arteriovenous malformation (AVM), their revealing conditions and their angio-architecture. To report their therapeutic management. Methods Retrospective monocentric study (from 1998 to 2018) focused on imaging proven thalamic AVMs among a cohort of 748 consecutive patients managed for a brain AVM at the Pitié- Salpêtrière Hospital. Revealing condition was systematically assessed. Safety and effectiveness of exclusion treatments were assessed on clinical and angiographic criteria. Results We included 21 patients with thalamic AVM (thalamic AVMs’ prevalence: 2.8%). Hemorrhagic event was the revealing condition of these thalamic AVMs in 90.5% of the cases. Posterolateral choroidal artery was the most frequently observed arterial feeder (70%). Aneurysms (either nidal or pedicular) were observed in 38% of the cases. Average nidal volume was 1.9 ± 13.3 cm3. Single venous drainage was seen in most cases (90%). Tree patients underwent a conservative treatment, 12 from radiosurgery and 12 from embolization. Complete AVM angiographic cure was achieved in 29.4% of the cases; 8 patients experienced a clinical complication, with 2 major complications but without any clinical consequence at long-term follow-up. Conclusion Our work allows for a better understanding of thalamic AVMs. Our results underline the safety of exclusion treatments by embolization and/or stereotaxic radiosurgery. Long-term effectiveness in terms of angiographic exclusion remains to be proven.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02276313
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Mariette Delaître. Malformations arterio-veineuses thalamiques : modes de présentation clinique, angio-architecture et prise en charge thérapeutique. Médecine humaine et pathologie. 2018. ⟨dumas-02276313⟩

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