Intracranial Arteriovenous Malformations
Conditions
Keywords
Intracranial Arteriovenous Malformations, Functional Magnetic Resonance Imaging, Neuronavigation
Brief summary
Little is known about the effect of fMRI navigation in the intracranial arteriovenous malformation surgery. The investigators aim to perform a multicenter prospective randomized single -blind clinical trial to assess the effect and safety of fMRI navigation in the brain arteriovenous malformation surgery.
Detailed description
Intracranial arteriovenous malformations (AVMs) are congenital lesions that consist of multiple arteries and veins, connecting as a fistula without an intervening normal capillary bed. Surgical removal is thought as a major treatment option for AVMs. However, compared with stereotaxic radiosurgery and endovascular embolization, microsurgery of AVMs is regarded with high mortality and morbidity, particular for high level classification AVMs . Blood oxygen level dependent fMRI can be used to mapping the motor and language regions of the brain noninvasively. It has been one of the most advanced functional imaging techniques and it has quickly grown to be a vital tool for clinical and cognitive neuroscience research. Many clinical researches have been reported about the utility of fMRI in brain tumor surgery. However, the effect of fMRI navigation for neurofunction protection in the intracranial arteriovenous malformation surgery was unclear. We aim to perform a multicenter prospective randomized single -blind clinical trial to assess the safety and effect of fMRI navigation in the intracranial AVMs surgery. We hypothesize that application of blood oxygen level dependent fMRI is able to improve long term prognosis of patients.
Interventions
PROCEDUREfMRI Navigation AVM resection
intraoperative fMRI navigation guided resection in AVM patients
PROCEDUREconventional resection
conventional resection in AVM patients
Sponsors
Beijing Tiantan Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
12 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Diagnosis of intracranial AVM by DSA/CT/MRI 2. Age from 12-60 years 3. Be suitable for microsurgery treatment 4. All patients are able to cooperate with the fMRI examination 5. All patients gave written informed consent
Exclusion criteria
1. Patients with age \< 12 years or \> 60 years 2. Various conditions unable to meet the indications for microsurgery treatment 3. Intracranial hemorrhage need emergency surgery 4. Patients can not cooperate with fMRI examination
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| modified Ranking Scale | six months after operation | The scale runs from 0-6, running from perfect health without symptoms to death. 0-No symptoms. 1. No significant disability. Able to carry out all usual activities, despite some symptoms. 2. Slight disability. Able to look after own affairs without assistance, but unable to carry out all previous activities. 3. Moderate disability. Requires some help, but able to walk unassisted. 4. Moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted. 5. Severe disability. Requires constant nursing care and attention, bedridden, incontinent. 6. Dead. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative complications | six months after operation | Post operative epilepsy seizure, hemorrhage,infarction. |
Countries
China
Contacts
Primary ContactYong Cao, MD
Outcome results
None listed