Abstract
The authors reported a co-operative study of 212 patients with an intracranial arteriovenous malformation (AVM). 123 cases initially bled, 12 cases had an ischemic attack (focal neurological deficits) and 48 patients were admitted with convulsive episodes. The 24 AVMs were incidentally diagnosed by CT scan and/or DSA examinations in patients with head injury or headache.
On the basis of size of the nidus, the AVMs were subdivided into 3 groups, small (3cm>), medium (3-6cm) and large (6cm<). The small group had the tendency to bleed and the large group tended to have convulsive or ischemic attacks.
154 cases were treated surgically and 52 were conservatively. Total removal of the AVM was performed in 140 cases and the postoperative mortality was 1.3%. On the other hand, subtotal removal of the AVM and/or clipping of the feeding arteries was performed in 14 cases, and of these 5 died from rebleeding. The conservatively treated group was followed up for 1 to 28 years (mean followup time 8.3 years). The mortality rate was 7.7%, which was rather lower than previous reports. But in these conservatively treated cases, 19 patients had re-attack and 8 of these patients had recurrence of bleeding within 10 years.
