Facebook

For individuals with a brain aneurysm or arteriovenous malformation (AVM), small interactions between blood flow and vessel distension might explain the difference between a catastrophic hemorrhage and a quiescent lesion.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

“Our research lab is attempting to figure out when an aneurysm or AVM is going to rupture by using computer analysis to catalog how blood vessels in the brain respond to various pressures and flow rates,” says Nina Moore, MD, a neurosurgeon and researcher with the Cerebrovascular Center in Cleveland Clinic’s Neurological Institute.

In the latest episode of Cleveland Clinic’s Neuro Pathways podcast, Dr. Moore discusses her lab’s research within the context of current procedural decision-making for cerebrovascular disorders and remaining questions around that decision-making. She touches on the following topics, among others:

Mechanisms underlying cerebrovascular disorders
Key differences between aneurysms and AVMs, and risk factors for each
Treatment options and approaches for both aneurysms and AVMs
Deciding when to intervene versus continuing surveillance

Click the podcast player above to listen to the 27-minute episode now or read on for a brief excerpt. Check out more Neuro Pathways episodes at clevelandclinic.org/neuropodcast or wherever you get your podcasts.

This activity has been approved for AMA PRA Category 1 Credit™ and ANCC contact hours. After listening to the podcast, you can claim your credit here.

Excerpt from the podcast

Podcast host Glen Stevens, DO, PhD: How widely is open surgery used for these conditions these days?

Nina Moore, MD: Use of open surgery for aneurysms has gone down considerably, just because we have a lot of catheter-based treatments that are very, very good. That said, there are still cases that are better suited for open surgery. I would say about 80% to 90% of aneurysm cases are treated with catheters. For AVMs, I’d say about 50% are treated with stereotactic radiosurgery and about 50% with open surgery.

Glen Stevens, DO, PhD: What happens if I have an aneurysm associated with my AVM?

Nina Moore, MD: Well, there’s literature to say that if you treat the AVM, the aneurysm may go away. I'm not 100% convinced about that. There are data to say that they have involuted, but I think we tend to treat those aneurysms if they look like they have high-risk features or are on the feeding artery of the AVM. And certainly in the posterior circulation, those AVMs tend to be found because the aneurysm is ruptured. If you see a PICA aneurysm, you should check to make sure the patient doesn’t have an AVM as well.