Staged Surgical Resection of Brain Arteriovenous Malformations.

World Neurosurgery
Eric S SussmanG K Steinberg

Abstract

Staged treatment of brain arteriovenous malformations (AVMs) is sometimes necessary to minimize risks associated with sudden changes in cerebral hemodynamics. With the increasing availability and optimization of endovascular techniques, multiple surgical resections are rarely necessary, although, due to specific anatomic circumstances, some AVMs still require staged surgery. Here, we describe the largest reported series of staged surgical resections of brain AVMs. This is a retrospective review of surgically resected AVMs at a single institution from 1998-2018. Patients who underwent ≥2 resections within 1 year were reviewed. Only those in whom initial resection was terminated with intention for further resection were included in analysis. Twenty patients underwent deliberately staged resection from 1998-2018. Average age at treatment was 36.2 years (SD 16.5 years). Eleven patients (55%) were female, and 12 (60%) had left-sided AVMs. Median Spetzler-Martin grade was 4 (interquartile range [IQR]: 3-4). Average AVM nidus diameter was 5.0 cm (SD 1.7 cm). Seven patients (35%) presented with AVM rupture, and 12 (60%) presented with focal neurologic deficits without hemorrhage. Seventeen patients (85%) underwent preoperative emboliza...Continue Reading

References

Jan 1, 1978·Clinical Neurosurgery·R F SpetzlerD Telles
Sep 1, 1987·Neurosurgery·B T Andrews, C B Wilson
Jul 22, 2008·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·S NishizawaK Uemura
Jul 22, 2008·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·K HongoS Mabuchi
Sep 25, 2008·Neurosurgery·Steven D ChangGary K Steinberg

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