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Intracranial arteriovenous malformations: an 11-year experience
1Department of Neurosurgery, Royal Alexandra Hospital for Children, Camperdown, NSW.
The Medical Journal of Australia
|January 18, 1988
Summary
Surgical treatment for intracranial arteriovenous malformations (AVMs) achieved high obliteration rates with lower mortality compared to conservative management. Morbidity was primarily linked to initial hemorrhage, not the surgery itself.
Area of Science:
- Neurosurgery
- Neurology
- Vascular Neurology
Background:
- Intracranial arteriovenous malformations (AVMs) pose significant risks.
- Treatment decisions for AVMs require careful consideration of risks and benefits.
Purpose of the Study:
- To analyze the outcomes of surgical and non-surgical management of intracranial arteriovenous malformations.
- To propose guidelines for the management of intracranial AVMs.
Main Methods:
- Retrospective analysis of 107 patients with intracranial AVMs treated between 1974 and 1985.
- Categorization of treatments: surgery with or without embolization, embolization alone, radiotherapy alone, and conservative management.
- Evaluation of mortality and morbidity rates across treatment groups.
Main Results:
- Surgery achieved complete obliteration in 69 of 71 attempted cases (97.2%).
- Surgical treatment had a 9.9% mortality rate and 22.3% morbidity, often related to initial hemorrhage.
- Non-surgically treated patients had a significantly higher one-year mortality rate compared to surgically treated patients.
Conclusions:
- Surgical intervention for intracranial AVMs is associated with favorable obliteration rates and reduced mortality.
- Conservative management of intracranial AVMs resulted in higher mortality.
- Guidelines for managing intracranial AVMs should prioritize surgical intervention when feasible.