Fults D, Kelly D L
Neurosurgery. 1984 Nov;15(5):658-62. doi: 10.1227/00006123-198411000-00003.
The natural history of intracranial arteriovenous malformations (AVMs) was studied in 131 patients. The 83 patients managed nonsurgically and the 48 patients treated surgically were followed for an average of 8 years. Hemorrhage occurred in 61.8% of all patients. A second hemorrhage occurred in 67.4% of the survivors of the first hemorrhage. The mortality associated with recurrent hemorrhage did not increase significantly with successive episodes of hemorrhage. The rate of rebleeding was 17.9%/year initially, but declined to 3%/year after 5 years and then to 2%/year after 10 years. Among patients treated nonsurgically, the prognosis was more favorable for patients presenting with seizures than for patients presenting with hemorrhage. Patients in the seizure group had a 26.9% incidence of hemorrhage causing an 11.6% mortality; 40.5% of the patients in the hemorrhage group died. The prognosis was poor for patients with posterior fossa AVMs; the mortality was 66.7% with the first hemorrhage. Recurrent posterior fossa hemorrhage was the rule in survivors, and most of those hemorrhages were fatal. The prognosis for children with AVMs was no different from that for adults.
对131例颅内动静脉畸形（AVM）患者的自然病史进行了研究。83例非手术治疗患者和48例手术治疗患者平均随访8年。所有患者中有61.8%发生出血。首次出血幸存者中有67.4%发生二次出血。与复发性出血相关的死亡率并未随着出血次数的增加而显著上升。最初再出血率为每年17.9%，但5年后降至每年3%，10年后降至每年2%。在非手术治疗的患者中，以癫痫发作为表现的患者预后比以出血为表现的患者更有利。癫痫组患者出血发生率为26.9%，死亡率为11.6%；出血组40.5%的患者死亡。后颅窝AVM患者预后较差；首次出血时死亡率为66.7%。后颅窝复发性出血是幸存者的常见情况，且大多数出血是致命的。AVM患儿的预后与成人无异。
