ARTERIOVENOUS-MALFORMATIONS OF THE BRAIN - INDICATIONS AND OUTCOME OFMICROSURGICAL EXCISION

This study is based on a retrospective analysis of 30 consecutive pati ents with previously untreated cerebral arteriovenous malformations (A VMs), who were seen at King Khalid University Hospital between 1987 an d 1994. There were 17 males and 13 females, ranging in age between nin e and 52 years. Twenty patients presented with intracranial hemorrhage , while the remaining 10 complained of epilepsy. The lesions were loca ted as follows: 15 at the convexity, seven interhemispheric, four cent ral, three basal, and one cerebellar. Nineteen patients (63%) underwen t microsurgical excision, which was complete in 16 and incomplete in t hree. There were no postoperative deaths. Fifteen patients had no addi tional postoperative neurological deficit, while four patients sustain ed neurological deterioration, which was severe in one. Two patients r efused surgical treatment and the risk of surgery was considered too h igh in nine patients. Our results suggest that the local neurosurgical management standard of selected AVMs is quite satisfactory. However, for a more comprehensive therapeutic approach to these difficult lesio ns, national expertise in other therapeutic modalities, such as emboli zation techniques and radiosurgery, is urgently needed.