Neuropediatrics 2018; 49(03): 227-228
DOI: 10.1055/s-0038-1635122
Book Review
Georg Thieme Verlag KG Stuttgart · New York

Brain Arteriovenous Malformations and Arteriovenous Fistulas

Eugen Boltshauser
1   Department of Pediatric Neurology, University Children's Hospital, Zurich, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
26 February 2018 (online)

Brain Arteriovenous Malformations and Arteriovenous Fistulas. Eds. A. S. Dumont, G. Lanzino, and J. P. Sheehan. New York: Thieme Medical Publishers; 2018 (274 pages). ISBN 978–1-62623–322–5. EUR ca 150.00 (e-book: eISBN 978–1-62623–323–2)

The editors (A. S. Dumont from New Orleans, G. Lanzino from Rochester, and J. P. Sheehan from Charlottesville – all neurosurgeons) have gathered 81 coauthors for this up-to-date volume on arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs). The book is organized into 31 chapters. The chapters are consistently well structured, including abstract, key points, and a conclusion, supplemented by multiple references. The print and the production of the figures is excellent. Two hundred fifty illustrations are included (anatomic views, colored artwork of the vascular anomalies, angiograms, computed tomography [CT], magnetic resonance imaging (MRI), intraoperative photographs, and selected videos demonstrating treatment modalities).

The editors have achieved their overriding aim to present contemporary clinical knowledge and multidisciplinary approaches. The chapters deal with classifications, physiology and hemodynamics, surgical aspects with focus on various AVMs locations, endovascular treatment for AVMs and AVFs in different anatomic regions, and radiosurgical considerations. In a comprehensive approach, other relevant topics are discussed, as preoperative/postoperative imaging evaluation; intraoperative imaging evaluation; intraoperative neurophysiological monitoring; and critical care and neuroanesthetic considerations. Some chapters are of particular interest to pediatric neurologists: Considerations for pediatric AVMs; Vein of Galen aneurysmal malformation; Syndromic AVMs; and Epilepsy management for AVM.

I found reading of this book very stimulating and informative. I can only support the statement of Dr. G. K. Steinberg in his foreword. “I learned a great deal from this book.”

It is beyond the scope of this book review to summarize the content in detail, but I like to mention some (subjective) learning points: Generally, most AVMs and AVFs occur sporadically without clear genetic basis (for exceptions see chapter on syndromic AVMs). Classification of AVMs and AVFs is critical to clinical decision-making and assessment of treatment risks, it is key to appropriate patient selection for treatment modalities. Arterial steal phenomena may occur in AVMs, not in AVFs. AVMs are congenital malformations; AVFs are usually acquired from venous hypertension and upregulated angiogenesis. Ruptured AVMs need to be treated due to the high risk of rerupture; the management of unruptured AVMs is still controversial. Between 50 and 65% of AVMs present with hemorrhage. Patients with infratentorial AVMs are more likely to present with hemorrhage. Following stereotactic radiosurgery, the latency period between treatment and obliteration of the AVM may be between 3 and 5 years, the risk of hemorrhage persists until nidal obliteration. In children, there is a risk of recurrence after successful obliteration of AVMs, which warrants longitudinal radiographic follow-up.

In summary, this book provides a wealth of information. It can be recommended to colleagues interested in neurovascular malformations.