TRANSCRANIAL DOPPLER ULTRASONOGRAPHIC CHANGES AFTER TREATMENT FOR ARTERIOVENOUS-MALFORMATIONS

We performed transcranial Doppler ultrasonography on 15 patients with arteriovenous malformations before and after embolization or surgical resection to compare quantitatively the hemodynamic effects of these two treatments. Changes in mean blood velocity and pulsatility index were analyzed in 19 treated feeding arteries. Blood velocity decreased by a mean of 38.1% or 46.5 cm/sec (p<0.0001, two-tailed paired t test); decreases were greater for surgically resected arteries (46.2% or 55.9 cm/sec, p<0.003) than for embolized arteries (30.8% or 38.0 cm/sec, p<0.0003). Pulsatility index increased by a mean of 54.7% or 0.25 (p =0.0001); increases were greater for surgically resected arteries (65.8% or 0.29, p=0.0045) than for embolized arteries (44.8% or 0.20, p<0.001). The differences in the changes in blood velocity and pulsatility index between treatment groups were not significant These data demonstrate that embolization results in hemodynamic changes that are qualitatively similar to those occurring after surgical resection of arteriovenous malformations. Transcranial Doppler ultrasonography is a reliable and convenient noninvasive method for monitoring hemodynamic effects of treatments for arteriovenous malformations. © 1990 American Heart Association, Inc.