Abstract
Serious morbidity and hyperemic states continue to complicate the treatment of certain intracranial arteriovenous malformations (AVMs). Clinical and radiographic characteristics of 62 patients treated over 3 years were analyzed to determine if hyperemic complications (HCs) (defined as unusual perioperative edema or hemorrhage) and outcome could be predicted. Twenty-five (40%) of the patients were less than 30 years old, 28 (45%) were between 30 and 50, and 9 (15%) were more than 50. A history of hemorrhage was found in 48%, and 34% presented with progressive deficits. Thirteen (21%) developed evidence of HCs; 51 (82%) ultimately had a good outcome, 4 (6%) had a poor outcome, and 7 (11%) died. The incidence of HCs was higher in patients whose AVMs recruited perforating vessels (53%) than those without (7%) (P < 0.001). The presence of preoperative angiographic steal carried a 35% risk of HCs whereas its absence carried a 13% risk (P < 0.05). The sum of the diameters of the feeding vessels was also predictive (P < 0.05). Outcome was clearly age-related: good outcome was achieved in 92% of the patients less than 30 years old, 86% of those 30 to 50, and 44% of patients older than 50 (P < 0.05). Left hemispheric AVMs showed less morbidity than right (P < 0.05) as did those without perforating vessel recruitment (P < 0.07). HCs had a dramatic impact on outcome with 92% of patients without HCs having good outcome and 46% of those with HCs recovering well (P < 0.001).
| Original language | English (US) |
|---|---|
| Pages (from-to) | 75-79 |
| Number of pages | 5 |
| Journal | Neurosurgery |
| Volume | 24 |
| Issue number | 1 |
| State | Published - 1989 |
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ASJC Scopus subject areas
- Clinical Neurology
- Surgery
Cite this
Intracranial arteriovenous malformation : Relationship between clinical factors and surgical complications. / Batjer, H. H.; Devous, M. D.; Seibert, G. B.; Purdy, P. D.; Bonte, F. J.
In: Neurosurgery, Vol. 24, No. 1, 1989, p. 75-79.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intracranial arteriovenous malformation
T2 - Relationship between clinical factors and surgical complications
AU - Batjer, H. H.
AU - Devous, M. D.
AU - Seibert, G. B.
AU - Purdy, P. D.
AU - Bonte, F. J.
PY - 1989
Y1 - 1989
N2 - Serious morbidity and hyperemic states continue to complicate the treatment of certain intracranial arteriovenous malformations (AVMs). Clinical and radiographic characteristics of 62 patients treated over 3 years were analyzed to determine if hyperemic complications (HCs) (defined as unusual perioperative edema or hemorrhage) and outcome could be predicted. Twenty-five (40%) of the patients were less than 30 years old, 28 (45%) were between 30 and 50, and 9 (15%) were more than 50. A history of hemorrhage was found in 48%, and 34% presented with progressive deficits. Thirteen (21%) developed evidence of HCs; 51 (82%) ultimately had a good outcome, 4 (6%) had a poor outcome, and 7 (11%) died. The incidence of HCs was higher in patients whose AVMs recruited perforating vessels (53%) than those without (7%) (P < 0.001). The presence of preoperative angiographic steal carried a 35% risk of HCs whereas its absence carried a 13% risk (P < 0.05). The sum of the diameters of the feeding vessels was also predictive (P < 0.05). Outcome was clearly age-related: good outcome was achieved in 92% of the patients less than 30 years old, 86% of those 30 to 50, and 44% of patients older than 50 (P < 0.05). Left hemispheric AVMs showed less morbidity than right (P < 0.05) as did those without perforating vessel recruitment (P < 0.07). HCs had a dramatic impact on outcome with 92% of patients without HCs having good outcome and 46% of those with HCs recovering well (P < 0.001).
AB - Serious morbidity and hyperemic states continue to complicate the treatment of certain intracranial arteriovenous malformations (AVMs). Clinical and radiographic characteristics of 62 patients treated over 3 years were analyzed to determine if hyperemic complications (HCs) (defined as unusual perioperative edema or hemorrhage) and outcome could be predicted. Twenty-five (40%) of the patients were less than 30 years old, 28 (45%) were between 30 and 50, and 9 (15%) were more than 50. A history of hemorrhage was found in 48%, and 34% presented with progressive deficits. Thirteen (21%) developed evidence of HCs; 51 (82%) ultimately had a good outcome, 4 (6%) had a poor outcome, and 7 (11%) died. The incidence of HCs was higher in patients whose AVMs recruited perforating vessels (53%) than those without (7%) (P < 0.001). The presence of preoperative angiographic steal carried a 35% risk of HCs whereas its absence carried a 13% risk (P < 0.05). The sum of the diameters of the feeding vessels was also predictive (P < 0.05). Outcome was clearly age-related: good outcome was achieved in 92% of the patients less than 30 years old, 86% of those 30 to 50, and 44% of patients older than 50 (P < 0.05). Left hemispheric AVMs showed less morbidity than right (P < 0.05) as did those without perforating vessel recruitment (P < 0.07). HCs had a dramatic impact on outcome with 92% of patients without HCs having good outcome and 46% of those with HCs recovering well (P < 0.001).
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M3 - Article
VL - 24
SP - 75
EP - 79
JO - Neurosurgery
JF - Neurosurgery
SN - 0148-396X
IS - 1
ER -