Türk Nöroşirürji Dergisi 2005 , Vol 15 , Num 3
LOW GRADE ARTERIOVENOUS MALFORMATIONS
Metin ORAKDÖĞEN, M. Zafer BERKMAN, Turgay ERSOY, Kaya KILIÇ, Mehmet Akif GÖĞÜSGEREN, Gökhan YILMAZ
SB Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, İstanbul OBJECTIVE: To assess the clinical and radiological features and surgical results of lowgrade arteriovenous malformations and emphasize the importance of the surgical choice.

METHODS: Twenty-two cases with Spetzler-Martin grade I-III cortico-subcortical arteriovenous malformation were operated in our clinic during the years 1999 and 2004 are reviewed retrospectively. Age and symptomatology of the patients, localizations and angiographic characteristics of the arteriovenous malformations, complete angiographic occlusion, morbidity and mortality rates were evaluated.

RESULTS: The mean age of the patients was 28.5. 86% of the cases presented us with an intracranial hemorrhage and 14% with epileptic seizure. Localizations of the arteriovenous malformations were supratentorial in 86.4%, and infratentorial in 13.6% of the cases. 10 cases were found to be Grade I, 8 cases Grade II, and 4 cases Grade III. Surgical excision was performed in all the cases. Control angiography was performed in eleven cases. The complete angiographic obliteration was verified in these cases. Operative morbidity was 13.6%, without any mortality. In 17 patients Glasgow Outcome Score was V, and in 5 patients it was IV at the time of discharge from the hospital. Rebleeding was observed in none of the cases during the follow-up period.

CONCLUSlON: In experienced hands, surgical excision is quite successfull with minimal operative morbidity. For patients carrying risks for general anesthesia, for patients who do not want surgical intervention, and for arteriovenous malformations in eloquent and deep locations, radiosurgery stands as an effective alternative of surgery. Anahtar Kelimeler : Arteriovenous malformation, Surgical resection, Radiosurgery, Intracerebral hematoma