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The difficulties associated with controlling the distribution and setting of the acrylate not only contribute to the instability of the embolization, but can also create other complications. For example, the catheter tip can become glued to the vessel wall (usually without further consequences). Worse, the draining vein can become occluded, causing a rupture or venous infarction. Embolization Techniques in the Treatment of Cerebral Arteriovenous Malformations 43 , a c b ~ __________________ ~~ ____ ~~ __________________________ ~ Fig.

Woman, 38 years old: transient ischemic attacks in the right hemisphere due to a high-flow AVM on the left side D. G. Tjan 48 . I, (, I I Fig. 2. After embolization there is a strong reduction in flow, an improvement in the fIlling of normal vessels, and a reduction in the size of the A VM Fig. 3. The picture after surgical excision Results of Combined Endovascular and Surgical Treatment 49 All AMVs removed were examined for their pathology. There was a strong lymphocytic reaction in the surrounding tissue and many foreign-body giant cells in the embolized cases only.

The skull base is closed with two layers of autologous material only: fascia lata and a pedicled pericranial flap. No bone grafts or any artificial material is used. 3 months). The long-term survival rate is 83%. Two of our 12 patients died due to local recurrences or distant metastasis between 10 and 13 months after surgery. 9 months, we have five (41 %) with tumor recurrence diagnosed 8-30 months postoperatively. 8 months. 2 months). Complications of the method are rare: in our series, one infected bone flap and one intracerebral hematoma of uneventful course (Table 2).

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Clumsy Hans


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