Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Spetzler-Martin grade IV and V arteriovenous malformations: Treatment outcomes and risk factors for negative outcomes after surgical resection.
First author：Jiao Yuming
Corresponding author：Cao Yong
essential_information
- Person in charge：Jiao Yuming
- Data Sources： OTHERS
- Number of papers：OTHERS20190768
- Published time：2019-03-01
2019-03-01
Published articles
Journal：J Clin Neurosci
Publication type: Article
IF(IF): 1.961
PMID: 30448296 Link To Pubmed Full text Download
Background And Purpose
Method
We retrospectively studied 53 consecutive patients with HBAVMs. All patients had undergone preoperative diffusion tensor imaging (DTI), MRI, 3D time-of-flight MRA (3D TOF-MRA) and digital subtraction angiography (DSA) followed by resection. White matter (WM) eloquent fibre tracts, including the corticospinal tract (CST), optic radiation (OR) and arcuate fasciculus (AF), were tract. Both functional, angioarchitectural and operative factors were analyzed with respect to the surgical outcomes.
Conclusion
This study identified that diffuse nidus, PA supplying and CST involving are risk factors for negative short-term outcomes in patients with HBAVMs. PA supplying, CST involving and postoperative ICH are risk factors for negative long-term outcomes. Larger nidus size was risk factor for postoperative ICH.
Main results
Nineteen (35.8%) patients suffered from negative surgical outcomes (MRS > 2) one week after surgery. At the last clinic visit, 10 patients (18.9%) suffered from negative surgical outcomes. Diffuse nidus (P = 0.018), Perforating arteries (PA) supplying (P = 0.009) and CST involving (P = 0.001) were independent risk factors for negative short-term outcomes. PA supplying (P = 0.039), CST involving (P = 0.026) and postoperative intracranial haemorrhage (ICH) (P = 0.014) were independent risk factors for negative long-term neurological outcomes. Larger nidus size (P = 0.024) was predictor of postoperative ICH. The cut-off point was 6.8 cm.