MANAGEMENT OF SMALL ARTERIOVENOUS-MALFORMATIONS OF THE BRAIN

A consecutive series of arteriovenous malformations of the brain, no g reater than 3 cm in diameter, referred to the author between January 1 989 and October 1994 is reviewed. Of these 42 cases 39 underwent surgi cal excision of the lesion. The surgical group had no mortality, 2.5% morbidity and 100% angiographic cure. Surgery in non-eloquent brain (n =21) resulted in no neurological morbidity and surgery in eloquent bra in (n=18) resulted in a 5.5% neurological morbidity. The reason for no t operating in three cases was elderly age in one, poor neurological c ondition in one, and involvement of the posterior limb of the internal capsule in one. Arteriovenous malformations with diameters no greater than 3 cm are considered by some to be suitable for treatment by focu ssed irradiation, However, surgery is likely to remain the more effect ive and safer mode of treatment for the majority of cases when factori ng in the expected complications of focussed irradiation during the la tency period. These risks are discussed. (C) Pearson Professional 1995