P.121 Open surgical trans-venous Onyx embolization of Rolandic arteriovenous malformations: case report and review of literature
Bibliographic record
Abstract
Background: Premature occlusion of draining veins during surgical resection of arteriovenous malformations (AVM’s) can lead to disastrous consequences. Interestingly, some authors have recently demonstrated effective endovascular trans-venous Onyx embolization of select AVM’s. Methods: Case report Results: A 71-year old female presented to the hospital with sudden onset right sided weakness and sensory change. Investigations revealed right fronto-parietal ICH secondary to a parasagittal Rolandic AVM with arterial supply from ACA and MCA branches. Drainage occurs via a single large cortical vein to the superior sagittal sinus. Partial intra-arterial embolization was initially performed. Surgical resection of the remaining nidus was deemed high risk. A craniotomy was performed and the large cortical draining vein was cannulated with a 4Fr micro-puncture system under direct visualization. A DMSO compatible micro-catheter was navigated retrograde close to the nidus. The draining vein was occluded using a surgical clip, and Onyx was immediately injected. Retrograde complete embolization of the AVM was observed. A total of 3ml of Onyx was injected, and the catheter was left in-situ. Patient was discharge 2 weeks later with minimal deficits. Conclusions: Open trans-venous embolization is a viable option for select AVM’s with a single draining vein and are not favorable candidates for trans-arterial embolization, surgery or radiation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".