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  • Title: [Long-term outcome of operatively and non-operatively managed high-grade intracranial arteriovenous malformations and factors influencing postoperative neurological deficits].
    Author: Deng ZH, Wang S, Zhao YL, Zhang D, Zhao JZ.
    Journal: Zhonghua Yi Xue Za Zhi; 2009 Mar 10; 89(9):606-9. PubMed ID: 19595160.
    Abstract:
    OBJECTIVE: To compare the effects of surgical and non-surgical treatments for high-grade intracranial arteriovenous malformation (AVM), identify the determinants of neurological function deterioration after surgery, and calculate the annual hemorrhage rate. METHODS: 98 high-grade intracranial AVM patients underwent surgery, and 44 high-grade intracranial AVM patients underwent conservative treatment. Follow-up was conducted on 141 of these 142 patients for (54+/-36) (6-118) months. MRI and DSA were conducted before and/or after treatment on most of the patients. Glasgow outcome score (GOS) was used to evaluate the neurological functions early and more then 6 months after discharge. The clinical data of these 142 patients were retrospectively analyzed. The annual hemorrhage rate associated with these lesions was calculated. RESULTS: The annual hemorrhage rate of these 142 patients was 2.1%. The integrated rate of late disability and mortality of the operative group was 10.1%, remarkably higher than that of the non-operative group (25.0%). AVM size, adjacent brain functional region, Spetzler-Martin grade, deep perforating arterial supply, and intra-operative bleeding volume were significantly correlated with early and permanent neurological function deficits. CONCLUSION: The long-term outcome of operatively managed intracranial high-grade AVMs is superior to that of the non-operatively treated ones. Spetzler-Martin grade and deep arterial perforating supply are the most important determinants of neurological deficit after microsurgical resection of AVM.
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