Clinical Study According to the Modality of Treatment of Cerebral Arteriovenous Malformations

ABSTRACT

A series of 44 patients with cerebral arteriovenous malformations(AVM's) treated by various modalities from January, 1987, to March, 1994, at Chung-Ang University Hospital were reviewed with emphasis on the outcome. Of these patients, 8 received conservative treatment, 16 only surgery, 4 combined embolization and surgery, and 16 embolization alone. The follow-up period ranged from 7 months to 54 months with a mean of 20.6 months. The efficacy of the combined treatment was evaluated by the complications and the clinical outcome. When compared with surgery alone, preoperative embolization facilitated surgery by reducing intraoperative bleeding and shortening the time of surgery. Clinical outcome was better after preoperative embolization, with no occurrence of major complications and mortality. Five AVM's were totally occluded by embolization alone, but of the 5 cases, 1 case was readmitted due to bleeding 2 years after the embolization. It is concluded that combined treatment with preoperative embolization and surgery was helpful in the management of large, high grade AVM's by reducing the complications associated with their surgical removal.