Cerebral arteriovenous malformation: report of 136 Chinese patients in Taiwan.

The authors studied 136 Chinese patients with verified cerebral arteriovenous malformations (AVMs) in Taiwan. Intracranial hemorrhage (ICH) was the leading problem at presentation (83.8%), followed by epileptic seizures (21.3%) and vascular headache alone (9.6%). Patients less than forty years old and/or with small AVMs (less than 20 ml) had a statistically significantly higher risk of bleeding (P less than 0.01 and P less than 0.05 respectively). The risk of rebleeding remained unchanged in both small (less than 20 ml) and large (greater than or equal to 20 ml) AVMs once ICH had occurred. The average annual bleeding rate of a nonbleed AVM with seizure alone was 1.7%. Seizures with a partial component could be identified in less than half of the epileptic patients, and EEG abnormalities were found in 85.7% of 45 studied cases. The difference in mortality between medically and surgically treated patients was not of statistical significance. The numbers for both morbidity and good recovery were higher in the surgical group. The rationale for selection of surgical cases is discussed.