Document Detail


Sylvian fissure arteriovenous malformations: long-term prognosis and risk factors.
MedLine Citation:
PMID:  23645140     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Sylvian fissure arteriovenous malformations (AVMs) are among the most challenging AVMs to manage surgically. The estimates of their risk factors and prediction of their long-term prognosis are crucial for clinical decision-making. The authors conducted a retrospective review to patients with sylvian AVMs treated microsurgically to evaluate the risk factors associated with long-term prognosis.
METHODS: Forty-one patients with sylvian fissure AVMs treated microsurgically between June 2009 and December 2011 were retrospectively reviewed with a mean follow-up time of 23 months (range 6-35 months). Chi-square test was utilized to compare proportions and rank-sum test to compare ordinal materials. Odds ratios (ORs) were used to assess risk factors associated with postoperative short-term outcome and long-term adverse outcome (mRS scores 3-6).
RESULTS: One patient died in 1 month after surgery. Eighteen (43.9%) patients had postoperative transient neurological deterioration. Good outcomes (mRS scores 0-2) were observed in 29 (72.5%) patients in the follow-up. From the multiple logistic regression, a history of AVM bleeding and deep venous drainage increase the risk of postoperative transient neurological deterioration, with OR = 8.211 and OR = 4.869, respectively. A history of AVM bleeding was a risk factor for long-term adverse outcome, with OR = 7.
CONCLUSIONS: Despite different Sugita classification subtypes, sylvian fissure AVMs' long-term results with microsurgical resection are better than expected; a history of AVM bleeding is a risk factor for postoperative temporary neurological deterioration and for long-term adverse outcome, while the AVM deep venous drainage is a risk factor only for temporary neurological deterioration.
Authors:
Lingtong Liu; Hao Li; Jian Zheng; Shuo Wang; Jizong Zhao; Yong Cao
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-05-05
Journal Detail:
Title:  Neurosurgical review     Volume:  36     ISSN:  1437-2320     ISO Abbreviation:  Neurosurg Rev     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-09-12     Completed Date:  2014-04-11     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  7908181     Medline TA:  Neurosurg Rev     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  541-9; discussion 549     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Analysis of Variance
Cerebral Angiography
Cerebral Cortex / anatomy & histology,  surgery
Child
Endovascular Procedures / methods*
Female
Follow-Up Studies
Headache / etiology
Humans
Intracranial Arteriovenous Malformations / complications,  pathology,  surgery*
Intracranial Hemorrhages / complications,  epidemiology,  etiology
Intraoperative Complications / epidemiology
Logistic Models
Magnetic Resonance Angiography
Male
Middle Aged
Neurosurgical Procedures / methods*
Prognosis
Retrospective Studies
Risk Factors
Seizures / etiology
Tomography, X-Ray Computed
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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