Hussain Saddam, Moez Abdul, Ali Akbar Aiza, Batool Syeda W, Akbar Amna, Ali Amir Iqbal, Umer Muhammad Rizwan, Sahar Amna
Neurosurgery, Combined Military Hospital, Rawalakot, PAK.
Neurosurgery, Ghurki Hospital, Lahore, PAK.
Cureus. 2025 Aug 6;17(8):e89498. doi: 10.7759/cureus.89498. eCollection 2025 Aug.
This study aimed to investigate the surgical management of cerebral arteriovenous malformations (AVMs) by analyzing clinical outcomes and complications in 600 patients (100%) who underwent surgery. The mean age of the cohort was 36.7 years (SD = 12.3), with a majority being female (n = 315, 52.5%). Patients were classified by AVM size: small (35.5%, n = 213), medium (31.5%, n = 189), and large (33%, n = 198). Surgical approaches included microsurgery (31.3%, n = 188), endovascular embolization (33.5%, n = 201), and radiosurgery (35.2%, n = 211). Surgical outcomes revealed that 33.8% (n = 203) achieved complete resection, 32.7% (n = 196) had partial resection, and 33.5% (n = 201) underwent no resection. Post-surgical complications were experienced by 51.5% (n = 309) of patients, with the most common being postoperative hemorrhage (15.2%, n = 91), infection (14.8%, n = 89), and seizures (9.8%, n = 59). Logistic regression identified AVM size (OR = 2.3, = 0.01), hypertension (OR = 1.8, = 0.03), and seizure history (OR = 1.7, = 0.04) as significant predictors of complications. Kaplan-Meier analysis revealed that patients with complete resection had the highest one-year recovery rate (78%), compared to partial (48%) and no resection (38%). Hospital stay was significantly longer for large AVMs (mean = 18.5 days) versus small AVMs (mean = 12.3 days; = 0.001). These findings underscore the importance of AVM size and patient comorbidities in predicting surgical outcomes and complications, highlighting the need for tailored treatment approaches.
本研究旨在通过分析600例接受手术治疗的患者（100%）的临床结局和并发症，探讨脑动静脉畸形（AVM）的手术治疗方法。该队列的平均年龄为36.7岁（标准差=12.3），大多数为女性（n = 315，52.5%）。患者按AVM大小分类：小型（35.5%，n = 213）、中型（31.5%，n = 189）和大型（33%，n = 198）。手术方法包括显微手术（31.3%，n = 188）、血管内栓塞（33.5%，n = 201）和放射外科手术（35.2%，n = 211）。手术结果显示，33.8%（n = 203）实现了完全切除，32.7%（n = 196）进行了部分切除，33.5%（n = 201）未进行切除。51.5%（n = 309）的患者出现了术后并发症，最常见的是术后出血（15.2%，n = 91）、感染（14.8%，n = 89）和癫痫发作（9.8%，n = 59）。逻辑回归确定AVM大小（比值比=2.3，P = 0.01）、高血压（比值比=1.8，P = 0.03）和癫痫病史（比值比=1.7，P = 0.04）是并发症的重要预测因素。Kaplan-Meier分析显示，完全切除的患者一年恢复率最高（78%），而部分切除（48%）和未切除（38%）的患者恢复率较低。大型AVM的住院时间（平均=18.5天）明显长于小型AVM（平均=12.3天；P = 0.001）。这些发现强调了AVM大小和患者合并症在预测手术结局和并发症方面的重要性，突出了采用个性化治疗方法的必要性。
