Pollock Bruce E, Brown Robert D
Department of Neurological Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Neurology. 2006 Nov 14;67(9):1630-4. doi: 10.1212/01.wnl.0000242738.60683.dd.
To present the results of arteriovenous malformation (AVM) radiosurgery using the Modified Rankin Scale (MRS) as the primary outcome measure and to analyze whether previous AVM rupture or other factors have an effect on outcomes after AVM radiosurgery.
We reviewed outcomes after AVM radiosurgery for 243 patients from 1990 and 2001. The mean follow-up after radiosurgery was 65 months.
Forty-one patients (17%) sustained a decline in MRS (median -2) after AVM radiosurgery. We noted a decline in MRS in 4% of patients 1 year after radiosurgery, 8% of patients at 3 years after radiosurgery, and 15% of patients at 7 years after radiosurgery. The radiosurgery-based AVM score correlated with a decline in MRS after AVM radiosurgery in multivariate testing (odds ratio 2.1; 95% CI 1.2 to 3.6; p < 0.01).
Previous AVM rupture did not influence neurologic deterioration after AVM radiosurgery. The radiosurgery-based AVM score predicted the chance of a worse MRS after radiosurgery.
以改良Rankin量表（MRS）作为主要结局指标，呈现动静脉畸形（AVM）放射外科治疗的结果，并分析既往AVM破裂或其他因素对AVM放射外科治疗后结局的影响。
我们回顾了1990年至2001年243例患者AVM放射外科治疗后的结局。放射外科治疗后的平均随访时间为65个月。
41例患者（17%）在AVM放射外科治疗后MRS评分下降（中位数为-2）。我们注意到，放射外科治疗后1年，4%的患者MRS评分下降；放射外科治疗后3年，8%的患者MRS评分下降；放射外科治疗后7年，15%的患者MRS评分下降。在多变量测试中，基于放射外科的AVM评分与AVM放射外科治疗后MRS评分下降相关（优势比2.1；95%可信区间1.2至3.6；p<0.01）。
既往AVM破裂不影响AVM放射外科治疗后的神经功能恶化。基于放射外科的AVM评分可预测放射外科治疗后MRS评分恶化的可能性。
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