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October 1962

Cerebrovascular Response to Emboli: Observations in Patients with Arteriovenous Malformations

Author Affiliations

Assistant Professor, Neurosurgery, Georgetown University Medical School, Research Consultant, National Institutes of Health, Attending Neurosurgeon, Mount Alto Veterans Administration Hospital (Dr. Luessenhop); Senior Assistant Resident (Dr. Gibbs), and Junior Assistant Resident (Dr. Velasquez), Neurosurgery, Georgetown University Hospital.; Department of Surgery (Neurosurgery), Georgetown University Hospital, Washington, D.C., and Division of Surgical Neurology, National Institutes of Health, Bethesda, Md.

Arch Neurol. 1962;7(4):264-274. doi:10.1001/archneur.1962.04210040016002

Introduction  Selective enlargement of the primary feeding arteries to large cerebral arteriovenous malformations and the relatively greater blood flow through these arteries can create direct, enlarged channels from the cervical carotid and vertebral arteries to the malformation. As these enlarged feeders enter the malformation they usually ramify into multiple smaller arteries, except in unusual cases of direct artery-to-vein communication.1,2 The anatomical and hemodynamic situation thus created may permit safe surgical embolization from the cervical arteries provided the emboli fit easily within these main channels and are too large for acceptance by the smaller side-branches to the surrounding normal brain.We are evaluating the extent to which artificial embolization may be useful in the treatment of certain large cerebral arteriovenous malformations and, with certain modifications, bleeding saccular aneurysms. Since reporting the first case, in which only 4 emboli were used,3 we have now studied the intravascular behavior of 471

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