Vilalta J, Arikán F, Noguer M, Olivé M, Lastra R, Martínez-Ricarte F
Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
Rev Neurol. 2007;44(8):449-54.
To conduct a descriptive analysis of a series of patients with arteriovenous malformations (AVM) that had been treated surgically.
Of a total of 189 adult patients with AVM evaluated consecutively in our hospital, 100 patients who had undergone surgical treatment were selected; a number of demographic, clinical and radiological aspects were then analysed, together with data concerning any associated vascular lesions, the type of surgical treatment, angiographic results and clinical outcomes.
The mean age was 34 years (range: 15-71 years). The most common presenting symptom was intracranial haemorrhage, which occurred in 60 cases (60%). The AVM were located in the supratentorial convexity in 79% of cases, 8% were deep and 13% were situated in the cerebellum. The most frequent degree, according to the Spetzler and Martin scale, was grade III. Seventeen patients had other associated lesions and it should be noted that eight patients had aneurysms. Most of the patients (78%) underwent elective surgery and, in two cases, post-embolisation. Surgical treatment (salvage surgery) was performed in 13 patients (13%) when other therapeutic options failed and seven patients were submitted to emergency operations because of brain haemorrhages. The postoperative angiographic study showed complete removal of the AVM in 98% of cases. The clinical outcomes were as follows: 75%, good recovery; 20%, moderate incapacity; and 5%, an important degree of incapacity.
Surgery is the best therapeutic option for patients with AVM, if they are selected in an appropriate manner.
对一系列接受手术治疗的动静脉畸形（AVM）患者进行描述性分析。
在我院连续评估的总共189例成年AVM患者中，选择100例接受过手术治疗的患者；然后分析了一些人口统计学、临床和放射学方面的情况，以及有关任何相关血管病变、手术治疗类型、血管造影结果和临床结局的数据。
平均年龄为34岁（范围：15 - 71岁）。最常见的首发症状是颅内出血，60例（60%）出现该症状。79%的AVM位于幕上凸面，8%位于深部，13%位于小脑。根据斯佩茨勒和马丁量表，最常见的分级为Ⅲ级。17例患者有其他相关病变，值得注意的是，8例患者有动脉瘤。大多数患者（78%）接受了择期手术，2例进行了栓塞后手术。当其他治疗选择失败时，13例患者（13%）接受了手术治疗（挽救性手术），7例患者因脑出血接受了急诊手术。术后血管造影研究显示98%的病例AVM被完全切除。临床结局如下：75%恢复良好；20%中度失能；5%严重失能。
如果选择合适，手术是AVM患者的最佳治疗选择。
