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Intracranial arteriovenous malformations: an 11‐year experience
Author(s) -
Morgan Michael K.,
Johnston Ian
Publication year - 1988
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1988.tb104508.x
Subject(s) - medicine , embolization , surgery , arteriovenous malformation , intracranial arteriovenous malformations , presentation (obstetrics) , intracranial haemorrhage , angiography , cerebral angiography , complication
A consecutive series of 107 patients with an intracranial arteriovenous malformation who were considered for surgical treatment over the 11‐year period between 1974 and 1985 is analysed. In 71 (66.4%) patients complete obliteration (which in some cases was combined with pre‐ or peroperative embolization) by surgery was attempted and was achieved in all but two patients. Five patients were treated by embolization alone and three patients by radiotherapy alone. Twenty‐eight patients were managed conservatively for one of four reasons: an expectation of a good outcome without treatment (six patients); the refusal of recommended surgical treatment (five patients); poor condition at presentation (eight patients); or the risks of operative treatment were thought to be too great (nine patients). There was a 9.9% mortality in the surgically‐treated series and significant morbidity in 16 (22.3%) patients. In all but two of these 16 patients, morbidity was related directly to the initial intracerebral haemorrhage. The one‐year mortality in the group that did not undergo operation was significantly higher than in those patients who were treated surgically. Some general guide‐lines for the management of intracranial arteriovenous malformations are proposed.