GRADING AND HEMODYNAMIC FOLLOW-UP-STUDY OF ARTERIOVENOUS-MALFORMATIONS WITH TRANSCRANIAL DOPPLER ULTRASONOGRAPHY

This study presents and tests the clinical validity of a hemodynamic g rading system that depends on noninvasive transcranial Doppler ultraso nographic parameters. The suggested transcranial Doppler-based grading system was compared with the Spetzler-Martin anatomic grading for pro gnosticative validity and clinical dependability. We concluded the fol lowing: (1) The pulsatility index was shown to be a more dependable tr anscranial Doppler parameter in the clinical evaluation of an arteriov enous malformation because of two reasons: preoperative pulsatility in dex findings inversely correlated with arteriovenous malformation volu me, and the pulsatility index returned to normal values before the mea n blood flow velocity did. Therefore, hemodynamic arteriovenous malfor mation grading can be based on the pulsatility index. (2) A transcrani al Doppler-based hemodynamic arteriovenous malformation grading system correlated highly with the Spetzler-Martin grading in predicting post operative neurologic deficits and adverse radiologic findings. (3) The presented grading system may contribute to the standardization and qu antification of the hemodynamic changes during multidisciplinary manag ement of arteriovenous malformations.