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Journal of Korean Neurosurgical Society 1987;16(1): 61-74. |
| A Clinical Analysis of Intracranial Arteriovenous Malformations. |
| Soon Han Yoon, Seung Kon Huh, Kyu Chang Lee |
| Department of Neurosurgery, Yonsei University, College of Medicine, Seoul, Korea. |
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| ABSTRACT |
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The author analyzed 66 cases of intracranial arteriovenous malformations treated in the Department of Neurosurgery of Yonsei University Hospital from 1977 to 1985. The results are summarized as follows : 1) The ratio of male to female was 2:1 and 75.8% or 50 cases were distributed between the 2nd and 4th decade. 2) The common presenting symptoms were either seizure alone(14%) or various symptoms resulting from hemorrhage(75%). 3) Arteriovenous malformations were suggested in 93.3% and were diagnosed in about half of the cases with the brain CT scan. Enhanced tubular shadow was the most important finding and hyperdensity of the lesion on precontrast brain CT scan was the most common finding. 4) The most common site of involvement was the supratentorial subcortical region with 75.4%, followed by the supratentorial deep region with 14.8%, and the infratentorial and dural region with 4.8%. 5) When compared to small(< 2cm) and large(> 4cm) lesions, there was less chance of hemorrhage in medium sized lesion(> 2cm to < 4cm).
When the subcortical and deep regions of the supratentorial lesion were compared, there was no difference in incidence of hemorrhage. 6) According to angiographic findings, 46.6% was grade I lesions. The anterior cerebral artery and the middle cerebral artery were most commonly involved. 7) After craniotomy, total resection was performed in 34 of 43 cases or 79.1%. Due to either size or location, 14.4% or 7 of 43 cases were inoperable. 8) Immediate postoperative neurological deficits were noted in 12.5% or 6 of 48 cases.
Non-hemorrhagic patients showed postoperative deficits more frequently than hemorrhagic patient did. 9) Regardless of treatment modality, there was a significant increase in number of patients who could be classified as grade I at discharge. 10) Long-term follow-up was carried out on 19 craniotomy cases. Neurological improvement was noted in 63.2% of these 19 cases. Among this group, there was no cases of neurological deterioration. |
| Key Words:
Arteriovenous malformation; Intracerebral hemorrhage; Seizure; Embolotherapy |
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