Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Microsurgical Outcome of Unruptured Brain Arteriovenous Malformations: A Single-Center Experience
First author：Tong, Xianzeng
Corresponding author：Zhao, Jizong
essential_information
- Person in charge：Tong, Xianzeng
- Data Sources： OTHERS
- Number of papers：OTHERS20190570
- Published time：2017-03-01
2017-03-01
Published articles
Journal：World Neurosurgery
Publication type: Research Article
IF(IF): 2.104
PMID: 28042014 Link To Pubmed Full text Download
Background And Purpose
Method
During a 7-year period, 282 patients with uBAVMs were surgically treated at our institution. Patient clinical features, postsurgical complications, arteriovenous malformation obliteration rate, seizure control, and functional outcome were collected and analyzed. Seizure control was evaluated with the Engel classification system. Patient functional outcome was assessed with modified Rankin Scale score.
Conclusion
Good functional outcome can be achieved by microsurgical resection in S-M grade I and II and selected grade III uBAVMs. Surgical resection for high-grade (grade IV and V) uBAVMs is challenging. A high seizure-free rate can be achieved in patients with initial seizure presentation.
Main results
Complete obliteration was achieved in 98.2% of cases. Surgical mortality rate was zero, and overall mortality rate was 1.1%. Good functional outcome (modified Rankin Scale score 0-1) was achieved in 86.9% of all patients, including 92.5% of patients with Spetzler-Martin (S-M) grade I and II uBAVMs, 80.6% of patients with S-M grade III uBAVMs, and 62.5% of patients with S-M grade IV and V uBAVMs. Poor outcome was significantly associated with arteriovenous malformation size ≥6 cm, deep venous drainage, eloquent location, and poor seizure control (all P < 0.05). For 177 patients with presurgical seizures, good seizure outcome (Engel class I) was achieved in 124 (70.1%) patients after microsurgical treatment. A short history of seizure occurrence, fewer presurgical seizures, and generalized tonic-clonic seizure type may be predictors of good seizure outcome (all P < 0.05).