[Neurosurgical treatment of cerebral arteriovenous malformations]

61 patients were treated from 1980 to 1984 for an arteriovenous malformation. Of these, 28 had suffered an acute haemorrhage, 33 were admitted for seizures, neurological deficits or intractable headaches. 55 patients underwent surgery. 4 patients rejected surgery and 2 malformations were not amendable to surgery. 55 patients were followed up for an average of 25 months (6-67 months), 53 of whom had undergone surgery. Good and excellent results were observed in 49 of 53 patients who had undergone surgery. 2 additional patients who were lost for follow-up had completely recovered and were without deficits on discharge. 4 patients who had undergone surgery for intracranial bleeding were moderately disabled on follow-up examination. No deaths occurred. There was a favourable effect of surgery on seizures. One half of the patients who had sporadic seizures preoperatively, remained without seizures without antiepileptic drugs. Of 9 patients who suffered from a manifest epilepsy preoperatively, 2 remained without seizures even without antiepileptic medication. We conclude from our results that not only arteriovenous malformations which have already bled but also those presenting with seizures, headaches, or neurological deficits, should be treated surgically unless they are not menable to surgery because of their location in the speech areas or the brain stem.