Makhambetov Yerbol, Maidan Aiman, Mammadinova Iroda, Menlibayeva Karashash, Kunakbayev Baurzhan, Dyussembaev Serik, Nurakay Nurtay, Makhambetov Nursultan, Almabayeva Aigul, Nurimanov Chingiz
National Centre for Neurosurgery, Astana 010000, Kazakhstan.
Taraz City Multidisciplinary Hospital and Consulting and Diagnostic Center, Taraz 080000, Kazakhstan.
Medicina (Kaunas). 2025 May 6;61(5):856. doi: 10.3390/medicina61050856.
: Arteriovenous malformations (AVMs) are abnormal connections between arteries and veins, lacking a normal capillary network. Seizures are a common clinical manifestation in patients with brain AVMs, ranking as the second most frequent presentation. The objective of this study was to evaluate the dynamics of seizure activity in patients with brain AVMs following surgical treatment. : This study included 27 patients with brain AVMs who underwent microsurgical AVM resection for symptomatic epilepsy. All surgical interventions were performed at JSC "National Centre for Neurosurgery" between 2008 and 2020. : Over an average follow-up period of 98.07 ± 45.6 months, 82 patients with brain AVMs underwent open microsurgical resection at the National Centre for Neurosurgery. Among them, 27 patients presented with seizures and had complete follow-up information, qualifying them for inclusion in this study. The participants had a mean age of 32.59 ± 9.06 years, with 13 of them being women. The Spetzler-Martin grading system was used to classify the AVMs: 6 patients had grade 1, 13 had grade 2, 7 had grade 3, and 1 had grade 4. More than half of the patients experienced generalized seizures. Microsurgical removal of the AVMs resulted in seizure remission for all patients. Only one patient experienced postoperative hemorrhage during the follow-up period. Additionally, one patient developed acute postoperative anemia, which resolved with a favorable outcome. : Microsurgical resection of brain AVMs, when performed with careful patient selection, leads to a significant reduction in seizure activity. It is a safe and effective treatment option for symptomatic epilepsy associated with brain AVMs.
动静脉畸形（AVM）是动脉与静脉之间的异常连接，缺乏正常的毛细血管网络。癫痫发作是脑AVM患者常见的临床表现，是第二常见的症状。本研究的目的是评估脑AVM患者手术治疗后癫痫活动的动态变化。
本研究纳入了27例因症状性癫痫接受显微外科AVM切除术的脑AVM患者。所有手术均于2008年至2020年在“国家神经外科中心”股份公司进行。
在平均98.07±45.6个月的随访期内，82例脑AVM患者在国家神经外科中心接受了开放性显微手术切除。其中，27例患者出现癫痫发作并具有完整的随访信息，符合纳入本研究的条件。参与者的平均年龄为32.59±9.06岁，其中13例为女性。采用Spetzler-Martin分级系统对AVM进行分类：6例为1级，13例为2级，7例为3级，1例为4级。超过一半的患者经历过全身性癫痫发作。显微手术切除AVM后所有患者癫痫发作缓解。随访期间只有1例患者发生术后出血。此外，1例患者出现急性术后贫血，最终预后良好。
精心选择患者进行脑AVM显微手术切除可显著降低癫痫活动。对于与脑AVM相关的症状性癫痫，这是一种安全有效的治疗选择。
