Turkish neurosurgery · 2019
Endovascular Therapy in Posterior Fossa Brain Arteriovenous Malformations: A Clinical Study.
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Uckun Ozhan Merzuk, Daglioglu Ergun
Аннотация
AIM: To assess posterior fossa brain arteriovenous malformation (PFbAVM) patients who received initial endovascular intervention to reduce the lesion size, as well as embolization for the obliteration of the lesions.
MATERIAL AND METHODS: This retrospective analysis included 16 patients (7 males and 9 females) with PFbAVMs who were treated between 2010 and 2017 via surgery, endovascular techniques, or combinations of modalities. Patient demographic and clinical features, angiographic characteristics, treatment modalities, complications, and outcomes were analyzed.
RESULTS: Six patients with cerebellar AVMs, 2 with brainstem AVMs, and 8 with cerebellarâ€"brainstem AVMs were included in this study. All patients were treated by endovascular embolization as initial or final treatment. Patient characteristics were assessed for all 16 patients; 7 (43.75%) presented with hemorrhage, and they were further treated by microsurgery because of residual niduses. Complete obliteration was obtained in all patients. Two patients had persistent neurological deficits. The outcome was measured with the modified Rankin scale (mRS). Serviceable outcome (mRS ≤ 2) was attained in 14 patients.
CONCLUSION: Successful treatment of PFbAVMs depends on an integrated team of neurosurgeons, radiosurgeons, and endovascular neurosurgeons. In PFbAVMs, endovascular embolization as adjuvant or final treatment is useful and safe.
MATERIAL AND METHODS: This retrospective analysis included 16 patients (7 males and 9 females) with PFbAVMs who were treated between 2010 and 2017 via surgery, endovascular techniques, or combinations of modalities. Patient demographic and clinical features, angiographic characteristics, treatment modalities, complications, and outcomes were analyzed.
RESULTS: Six patients with cerebellar AVMs, 2 with brainstem AVMs, and 8 with cerebellarâ€"brainstem AVMs were included in this study. All patients were treated by endovascular embolization as initial or final treatment. Patient characteristics were assessed for all 16 patients; 7 (43.75%) presented with hemorrhage, and they were further treated by microsurgery because of residual niduses. Complete obliteration was obtained in all patients. Two patients had persistent neurological deficits. The outcome was measured with the modified Rankin scale (mRS). Serviceable outcome (mRS ≤ 2) was attained in 14 patients.
CONCLUSION: Successful treatment of PFbAVMs depends on an integrated team of neurosurgeons, radiosurgeons, and endovascular neurosurgeons. In PFbAVMs, endovascular embolization as adjuvant or final treatment is useful and safe.