Department of Neurosurgery, University Hospital, Düsseldorf, Germany.
Department of Neurosurgery, Kantonsspital Aarau, Tellstr. 25, 5001, Aarau, Switzerland.
Neurosurg Rev. 2021 Dec;44(6):3165-3175. doi: 10.1007/s10143-021-01526-0. Epub 2021 Apr 10.
Considerable progress has been made over the past years to better understand the genetic nature and pathophysiology of brain AVM. For the actual review, a PubMed search was carried out regarding the embryology, inflammation, advanced imaging, and fluid dynamical modeling of brain AVM. Whole-genome sequencing clarified the genetic origin of sporadic and familial AVM to a large degree, although some open questions remain. Advanced MRI and DSA techniques allow for better segmentation of feeding arteries, nidus, and draining veins, as well as the deduction of hemodynamic parameters such as flow and pressure in the individual AVM compartments. Nonetheless, complete modeling of the intranidal flow structure by computed fluid dynamics (CFD) is not possible so far. Substantial progress has been made towards understanding the embryology of brain AVM. In contrast to arterial aneurysms, complete modeling of the intranidal flow and a thorough understanding of the mechanical properties of the AVM nidus are still lacking at the present time.
在过去的几年中，人们在更好地理解脑动静脉畸形的遗传本质和病理生理学方面取得了相当大的进展。为了进行实际的综述，我们在 PubMed 上进行了有关脑动静脉畸形的胚胎学、炎症、高级成像和流体动力学建模的搜索。全基因组测序在很大程度上阐明了散发性和家族性脑动静脉畸形的遗传起源，尽管仍存在一些悬而未决的问题。高级 MRI 和 DSA 技术可以更好地分割供血动脉、病灶和引流静脉，并推导出血流和压力等血流动力学参数在各个脑动静脉畸形隔室中的分布。然而，目前仍然不可能通过计算流体动力学（CFD）对病灶内的流场结构进行完整的建模。目前，人们在理解脑动静脉畸形的胚胎学方面取得了重大进展。与动脉动脉瘤不同，目前仍然缺乏对病灶内血流的完整建模以及对脑动静脉畸形病灶的机械特性的透彻理解。
