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Abstract
Brain aneurysms are pathologic focal dilatation of the cerebrovasculature that are prone to rupture while AVMs are congenital clusters of abnormal arteries and veins. Both can cause cerebral hemorrhage, with devastating consequences for the patients and their families. They usually present by serious neurological manifestations with associated high morbidity and mortality rates.
They have an incidence of about 1% and 0.1% in general population respectively yet their exact pathogenesis is not well understood.
Imaging modalities for assessment of cases with intra cranial aneurysm and AVMs include DSA, CT, CTA, MRI and MRA.
Multi-slice CTA has become important in the investigation of intra cranial vessels due to its non-invasiveness, reliability, feasibility, speed and inexpensiveness. It shows promising diagnostic accuracy which appears to be equivalent to conventional DSA for detection of suspected intracranial aneurysms. CTA provides enough anatomical information for treatment planning in the majority of cases. A strategy of using CTA as the primary imaging method, with DSA reserved for any cases of uncertainty, appears safe and reliable.
The conventional method of treating intracranial aneurysms and AVMs has been surgery, yet surgery is invasive and associated with high morbidity and mortality rates, so a new management strategy in the form of endovascular therapy have been developed in an attempt to minimize these risks and to improve clinical outcome for patients with intra cranial aneurysms and AVMs.
The recent advances in materials used in neuro-interventional techniques such as catheters, guide wires, coils, stents, balloons and embolizing materials facilitate the improvement of these techniques and allow for more and more successful clinical applications.