Anesthésie en neuroradiologie interventionnelle (2e partie)Â : malformations artérioveineuses cérébrales

Intracranial arteriovenous malformations (AVM) can be treated by a combination of surgery, radiotherapy and endovascular treatment. Embolization requires complex endovascular navigation and supraselective injections directly within the nidus of the AVM. Impairment of local blood flow after embolization can cause life threatening intracranial hypertension and intracranial haemorrhage resulting from normal perfusion pressure breakthrough (NPPB). Systolic arterial pressure should be monitored and kept below 100 mmHg within an ICU setting as these complications may occur until one week after embolization. In case of intracranial haemorrhage, the objectives would be lowering intracranial pressure and systemic arterial pressure to prevent further intracranial bleeding while keeping cerebral perfusion pressure within acceptable limits.