[Surgery of intracerebral arteriovenous malformations: the anesthesiologist's point of view. Report of 50 cases].

This retrospective study was undertaken in order to analyse the application of the grading scheme of Spetzler and Martin to a series of 50 excised arteriovenous malformations. The frequency distribution of scores was as follows score II, 21 cases; score III, 18 cases; score IV, 7 cases and score V, 4 cases. Neurological deficit (54%), intracerebral hematoma (34%), intraventricular (12%) and subarachnoid hemorrhage (24%), epileptic seizure (26%), difficulty of surgery duration (8.1 h +/- 2.8), per-operative bleeding and coagulation abnormalities (14%), post-operative morbidity (early postoperative neurological status, duration of controlled ventilation and stay in Intensive Care Unit) and outcome were taken as target variables. Youth has a favorable influence on outcome: 100% of patients less than 30 years have a good outcome, whereas 88% of the 30 to 50 years old group and 67% of the patients older than 50 years have a similar favorable recovery. According to these factors, the clinical grading scale of Spetzler and Martin seems to provide a good pre-operative evaluation of surgical risks.