AI Article Synopsis

  • The study aimed to assess the surgical outcomes and prognosis factors for patients with intracranial giant arteriovenous malformations (AVMs) treated at Beijing Tiantan Hospital, involving 46 cases with a mean age of 30.6.
  • Post-surgery complications were noted in 9 patients, with one death occurring; however, most surviving patients (33 out of 37) reported normal or minimal residual symptoms during follow-up ranging from 6 to 108 months.
  • The findings suggest that thorough pre-surgical evaluation and an appropriate treatment plan are crucial, with microsurgery proving effective for removing giant superficial AVMs, generally yielding acceptable complication rates.

Article Abstract

Objective: To review surgical outcomes in treating intracranial Giant arteriovenous malformations (AVMs). To find out the prognosis factors of surgical treatment.

Methods: We collected 46 consecutive cases of giant AVMs treated at Beijing Tiantan Hospital, reviewed the radiological and Spetzler-Martin grading. 25 of the patients selected were male (54%), and 21 were female (46%), with a mean age of 30.6. The major presenting symptoms were seizures, headaches, hemorrhage and neurological deficits. According to the Spetzler-Martin Grading, 8 patients were Grade III, 22 were Grade IV, and 16 were Grade V. All patients received surgical treatment and postoperative DSA were performed. Clinical results and long term follow-up (KPS) were gathered for analysis.

Results: One of the 35 patients who received postoperative DSA revealed residual AVMs. Among all patients, severe complications were observed in 9 patients, and 1 patient died in the hospital. Complications included hemiparalysis (15 cases), aphasia (6 cases), hemianopia (9 cases), cranial nerve dysfunction (5 cases), and seizure (5 cases). Normal perfusion pressure breakthrough (NPPB) was observed in 6 patients. After 6 - 108 months of follow-up, 33 of 37 survived follow-up patients presented normal function or minimal symptoms and ability to work or study, 4 patients died (2 were surgical-related).

Conclusion: Pre-surgical evaluation of every candidates and treatment choice are the determining factors in giant AVMs therapy. Microsurgery remains one of the most effective ways for eliminating giant cerebral AVMs, and the complication rate was acceptable. For giant cerebral AVMs located superficially or do not involve critical components, a good outcome can be expected through surgical resection.

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