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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
[Arteriovenous Malformations - checking and descriptive analysis of 52 AVMs treated for the 2000-2010 period]
Mariano Rinaldi1, Emilio Mezzano1, Matias S Berra1
1Department of Neurosurgery, Córdoba Hospital, Avenida Patria y Libertad, Córdoba, Argentina.
Background:
To describe our experience in treating AVMs based on age, sex, reasons for consultation and symptoms, localization and clinical diagnosis, size, types, relation with aneurysms, endovascular procedures used, postoperative results and complications.
Methods:
We present 52 patients with AVMs, analysing Neurological Exam, Ct, Irm and Brain Arteriography.
Results:
Average age: 37.71 years. Male patients 61.53% females 38.46%. Reasons for consultation Cephalea: 63.46%, hemorrhagic events: 59.61%, seizures 26.92%. AVM location: supratentorial: 92.85%, infratentorial: 7.15%. AVMs frequency: grade 2: 30.76%, grade 3: 30.76%. Of the total number 50%, presented associated aneurysms. 32.69% of them presented hemorrhagic events. Of the total of AVMs, 59.61% showed bleeding, 26.92% showed seizures and 13.46% showed neurological deficit. 30.76% of the patients received endovascular treatment 23.07% improved their clinical condition, 57.69% showed no changes, and 19.23% experienced deterioration during the postoperative period. There were 13.46%. Mortal cases.
Conclusion:
We agree with the authors that the group mostly affected is (20- 40 years). As regards sex distribution: male patients (61.53%) female ones (38.46%). AVM location was mostly supratentorial, but also that cephalea, hemorrhagic events and seizures were the most frequent symptoms and reasons for consultation. Hemorrhagic CVA, cephalea, epileptic seizures and neurological deficit represented the most common admission diagnoses. We believe that the subgroup of AVMs grade III, IV and V has unique features that requiring extreme care when making decisions. The mortal cases in the postoperative period coincided with those mentioned in the bibliography consulted.
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