Abstract
The treatment of intracranial AVM's is one of the most difficult problems in neurosurgery. Especially large AVM's and AVM's on the eloquent area are the most challenging operation because of the postoperative NPPB or functional damage. Therefore the purpose of this paper is to clarify the treatment of intracranial AVM's. 126 cases of intracranial AVM's were operated on in our university hospital from Jan. 1977 to April 1989, including 101 cases of direct operation and 25 cases of embolization.
(Method) 1) A matching study was done to compare the results of liquid embolization and direct operation in cases of the same location and size. 2) CT, MRI, angiography and SPECT were taken pre- and post-operatively to evaluate NPPB. 3) With AVMs on the motor cortex, surgical excision was performed under MEP monitoring. 4) Preoperative embolization was done in the cases in which feeding arteries were located deep and were difficult to appraoch.
(Results) 1) Liquid embolization was a good indication for dural AVM. Surgical excision was better for cerebral AVM's. 2) Preoperative embolization with IBCA+myodil+tantalum powder was useful for large AVMs with hidden feeding artery.
