[Arteriovenous malformations of the brain: personal experience with 121 patients treated with microsurgery].

INTRODUCTION: Arteriovenous malformations (AVM) can be found in 0.1% of the population, and the most frequent presenting symptom is intracranial haemorrhage.

AIM: To conduct a descriptive analysis of a series of cases of AVM that had been treated surgically by a neurosurgeon.

PATIENTS AND METHODS: The cases of AVM treated surgically by the author over the period 1990 to May 2014 were selected from a hospital register, and then the clinical, demographic and angiographic aspects were reviewed, together with the clinico-radiological findings six months after surgery.

RESULTS: Of the 400 patients treated over that same period, 121 were operated on by the author, their mean age being 34.3 years (range: 5-75 years). 61.7% of the patients were diagnosed due to a brain haemorrhage, and the second most frequent presenting symptom, in 19.8% of them, was because of epileptic seizures. A superficial supratentorial localisation, occurring in 97 cases (80.2%), was the most common. Over half the patients presented a low-grade AVM, I-II, according to the Spetzler and Martin scale. Twelve patients (10%) had associated non-intranidal aneurysms. In most cases, 109 (90.1%), elective surgery was performed. Complete resection of the AVM after the last angiographic examination was achieved in 118 patients (97.5%). The clinical results were good (good recovery and moderate disability) in 114 cases (95%), and poor (great disability and death), in six (5%).

CONCLUSIONS: Surgery is the best therapeutic option for many patients with AVM, if appropriate selection criteria are used.