1996 Volume 24 Issue 6 Pages 417-420
We retrospectively analyzed operative results in 28 cases of intracerebral arteriovenous malformations (AVM's) operated on at the National Cardiovascular Center over the past three years. Intractable brain swelling and/or diffuse hemorrhage immediately after removal of an AVM was not experienced in the present series. There was one case of postoperative bleeding attributable to uncontrolled arterial hypertension just after the operation, in which total resection was confirmed by intraoperative angiography.
There was another case of a large high-flow AVM, in which discontinuance and resumption of hypotension after total resection showed brain swelling and shrinkage. This case was treated successfully with mild hypotension, hypothermia and barbiturate coma after the surgery. All the other cases were treated successfully.
Based on our limited experience of total resection of AVMs, we have concluded that when the surgery is technically successful and the perioperative blood pressure is appropriately controlled, uncontrollable hemodynamic state after resection of an AVM occurs very rarely.
