Open AccessNatural course of the arteriovenous malformations of the brain
Author(s) -
Goran Tasić,
Aleksandar Kostić,
B.M. Djurovic,
Vesna Jovanović,
Igor Nikolić,
Éric Azabou,
Miloš Joković,
Mirko Mićović
Publication year - 2008
Publication title -
acta chirurgica iugoslavica
Language(s) - English
Resource type - Journals
eISSN - 2406-0887
pISSN - 0354-950X
DOI - 10.2298/aci0802107t
Subject(s) - medicine , embolization , angioma , natural history , epilepsy , arteriovenous malformation , vein , radiation therapy , radiology , surgery , intracranial arteriovenous malformations , hemangioma , vascular disease , angiography , cerebral angiography , psychiatry
Arteriovenous cerebral malformations represent congenital malformations. Considering the anatomical characteristics of the cerebral angiomas and their localization, in a great number of cases they demand a combined therapeutic approach--surgery, embolization and radiotherapy. Besides the constant progress of technology, 5% of all cerebral angiomas can not be completely excluded from the circulation. Therefore, the need to understand their natural course became a necessity. Our results point to the fact that they are vascular malformations of a considerably more benign clinical course than the aneurysms. Our clinical model points to an annual risk of hemorrhage which is 3.3% with total mortality of 5.3%, especially if the size of the angioma is 2.5-5 cm, localized in the motor zone of the brain, with combined type of vein drainage and arterial supply from the vertebrobasilary confluence. Epilepsy caused by the cerebral angioma is in 26.7% refractory to medicamentous therapy and in 25% (every 4th patient) will have hemorrhage with an annual risk of 0.14%.