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Pure sylvian fissure arteriovenous malformations
G Zimmerman1, A I Lewis, J M Tew
1Department of Neurosurgery, University of Cincinnati College of Medicine, Ohio 45267-0515, USA.
Journal of Neurosurgery
|January 1, 2000
Summary
Microsurgery effectively treats pure sylvian fissure arteriovenous malformations (AVMs), even those considered inoperable. While transient deficits occurred, all patients achieved excellent outcomes with improved neurological function and symptom relief.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Neuroradiology
Background:
- Pure sylvian fissure arteriovenous malformations (AVMs) are challenging due to their location and proximity to critical brain structures.
- These AVMs are often deemed inoperable because they involve arteries of passage and have ill-defined margins with the insula cortex.
Purpose of the Study:
- To evaluate the surgical outcomes and incidence of operative morbidity in patients with pure sylvian fissure AVMs.
- To determine the efficacy of microsurgery as a primary treatment for these complex vascular malformations.
Main Methods:
- A retrospective review of eight patients with pure sylvian fissure AVMs who underwent surgical treatment.
- Surgical outcomes were assessed through clinical evaluation, neurological examinations, and postoperative angiography.
Main Results:
- Complete AVM removal was achieved in all eight patients, confirmed by angiography.
- Seizures and headaches were resolved in all affected patients.
- Transient neurological deficits (aphasia, memory loss, hemiparesis) occurred in 50% of patients but resolved within 3 months, with overall functional independence achieved.
Conclusions:
- Microsurgery is a safe and effective primary treatment for pure sylvian fissure AVMs, yielding excellent outcomes.
- Despite transient postoperative morbidity, the long-term results support surgical intervention for these AVMs.
- The study advocates for microsurgery as the preferred treatment modality for pure sylvian fissure AVMs.