RESUMO
Brain arteriovenous malformations (AVMs) often present treatment challenges. Patients with unruptured AVMs must consider not only whether they want to be treated, but what treatment modality they would prefer. Vascular neurosurgeons, neurointerventional surgeons, and stereotactic radiosurgeons must in turn guide their patients through the most appropriate treatment course considering the risk of AVM rupture, an individual AVM's characteristics, and patient preferences. In this review we will look at how the clinical trial "A Randomized Trial of Unruptured Brain Arteriovenous Malformations (ARUBA)" has influenced the approach to unruptured brain AVMs and the treatment modalities available to clinicians to deal with these formidable lesions.
Assuntos
Artéria Carótida Primitiva , Cateterismo Periférico , AVC Isquêmico/terapia , Trombectomia , Fatores Etários , Artéria Carótida Primitiva/diagnóstico por imagem , Criança , Feminino , Humanos , AVC Isquêmico/diagnóstico por imagem , Punções , Trombectomia/efeitos adversos , Terapia Trombolítica , Resultado do TratamentoRESUMO
The authors looked at all of the pediatric patients with a head injury who were transferred from other hospitals to their own over 12 years and tried to identify factors that would allow patients to stay closer to home at their local hospitals and not be transferred. Many patients with isolated, nondisplaced skull fractures or negative CT imaging likely could have avoided transfer. While hospitals should be cautious, this may help families stay closer to home.
