Author(s): Sunderland G.; Hussain M.; Franceschini P.; Puthuran M.; Byrne P.; Nahser H.; Farah J.; Eldridge P.

Source: British Journal of Neurosurgery; 2018; vol. 32 (no. 1); p. 96-97

Publication Date: 2018

Publication Type(s): Conference Abstract

Abstract:Objectives: To review surgical management of arteriovenous mal-formations (AVM), assessing presentation and indication for treat-ment and correlating this with outcomes. Methods: Retrospective case note analysis of patients who underwent surgical excision of their AVM between 2007-2015. Results: 358 patients were reviewed for management of their AVM between 2007-2015, of these 77 underwent surgical resection (21%) and the rest had either SRS, embolisation or conservative treatment. 37 of the 77 surgical patients had embolization prior to surgery and 6 patients had SRS prior to surgical resection. The age range was 16-72 years, a majority of surgery was secondary to haemorrhage (52%) however AVMs were also resected for seizure management (19%) and those found as incidental AVMs (29%). A majority of the AVMs were Spetzler-Martin grade 2 (G1 (10), G2 (30), G3 (16), G4 (10), G5 (2)). 52 patients had a MRS 2 or below prior to surgery and post-surgery this improved to 58. 17 patients had a permanent visual field deficit, 9 had cognitive problems and 6 with speech disturbance. All patients have had a follow up cere-bral angiogram and there was no residual AVM seen after surgical resection. Conclusions: Surgical resection of AVMs in this unit has favourable outcomes with complete resection demonstrated in all cases. Spetzler-Martin Grade is taken into account when making the decision to treat however the whole clinical picture is required and a single measure alone cannot predict outcome.

Database: EMBASE