Latest - (Latest / 1. What is an arteriovenous malforma...

Vascular disorders (PEARLS) (Smarty PANCE) (Latest /

• What is an arteriovenous malformation?

Answer: Arteriovenous malformation is when a group of arteries directly link up with a group of veins instead of through capillaries.

• What is the most common manifestation of brain arteriovenous malformations?

Answer: The most common manifestation of brain arteriovenous malformations is intracranial hemorrhage. AVNs are the second most common cause of subarachnoid hemorrhage in the brain

• What are the most common arteries affected by the arteriovenous malformations?

Answer: The posterior branches of the middle cerebral artery are the most common arteries affected by the arteriovenous malformations.

• What is Osler-Weber-Rendu syndrome?

Answer: Osler-Weber-Rendu syndrome is an autosomal dominant vascular disorder that presents with arteriovenous malfor- mations and other blood vessel problems throughout the body. Also known as Hereditary hemorrhagic telangiectasia syndrome.

• How does CT scan compare to MRI in detecting central nervous system arteriovenous

malformations?Answer: CT scan is less sensitive than MRI in detecting central nervous system arteriovenous malformations

• What is the grading system used for preoperative risk-stratification of brain arteriovenous

malformations?Answer: The Spetzler-Martin grading system is used for preoperative risk-stratification of brain arteriovenous malformations

• What is used for the treatment of patients with brain arteriovenous mal- formations who

are not surgical candidates?Answer: Radiotherapy is used for the treatment of patients with brain arteriovenous malformations who are not surgical candidates

• What can happen as a result of the heart having to work harder in people with

arteriovenous malformations?Answer: Because the heart has to work harder in people with arteriovenous malformations, this can lead to high-output heart failure

• What is the gold standard for the diagnosis of brain arteriovenous mal- formations?

Answer: Cerebral angiography is the gold standard for the diagnosis of brain arteriovenous malformations

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• What is a cerebral aneurysm?

Answer: A cerebral aneurysm or an intracranial aneurysm, is a weak bulging spot on the wall of a brain artery very much like a thin balloon or weak spot on an inner tube.

• How are cerebral aneurysms classified?

Answer: Cerebral aneurysms are classified both by size and shape

Small aneurysms have a diameter of less than 15 mm Larger aneurysms include those classified as large (15 to 25 mm) Giant (25 to 50 mm), and supergiant (over 50 mm)

• A small sac-like aneurysm of a cerebral artery. Most often found in the circle of Willis in

the brain circulation Consists of a small, spherical vessel dilation

Answer: Saccular ("berry") aneurysm

• Circumferential enlargement of a vessel with tapering at both ends

Answer: -Fusiform aneurysm

• Weakening of the arterial wall caused by a closed head injury or penetrating trauma to the

brain.

Answer: Traumatic aneurysm

• A dilation of an artery due to damage of the vessel wall by an infection which can be

bacterial, fungal, or viral in origin;

Answer: Mycotic aneurysm

• Accounts for approximately 75% of nontraumatic cases of subarachnoid hemorrhage

(SAH) and has a mortality rate of 50%.

Answer: Ruptured saccular (berry) aneurysm

• Classic SAH Presentation?

Answer: The classic SAH presents as sudden onset of an unusually severe, generalized headache, which patients may describe as "the worst headache I've had in my life." The headache may be accompanied by nausea and vomiting, seizure activity, or an altered state of consciousness.

• What is the gold standard for the diagnosis of cerebral aneurysm?

Answer: Cerebral angiography (Gold Standard) should be done to evaluate the entire vasculature when convenient because as many as 20% of individuals will have multiple aneurysms.The gold standard for diagnosis is cerebral angiography. We don't typically start with angiography, we will start with imaging such as CT or MRA because it is less sensitive but easier to perform. But if the question asks you what is the Gold Standard for cerebral aneurysm the answer is angiography

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