Study on choice of treatment of Cerebral Arteriovenous Malformation: a review of 36 cases.

Objective To analyze the choice of treatment of Cerebral Arteriovenous Malformation(AVM). Methods Clinical data obtained from 36 patients with AVM treated by three methods were analyzed retrospectively, and reviewed with literatures of 36 AVM cases, 9 cases treated with operating excision, 10 cases treated with endovascular embolization ,4 cases treated with the gamma knife(γ- knife) ,2 cases treated with operating excision after endovascular embolizations, 11 cases treated with gamma knife after endovascular embolizations. Results Of 36 patients, angiography showed disappearance of AVM nidus in 8 cases of microsurgery and 11 cases of operating excision after endovascular embolizations; Reexamination of 4 cases treated by γ- knife showed the AVM nidus disappearance or reduced; for 10 cases of endovascular embolization and 11 cases of γ- knife after endovascular embolizations, Com plete embolization ( 95 %) was done in 4 cases, 80% in 7cases, 50% in 8 cases. In follow-up, there were 25 cases (69. 4%) in GOS grade 5; 7 cases(19.4%) in grade 4,thereinto, 3 cases had headache left, 4 cases had epilepsies left; 3 cases(8. 3%) in grade 3 which had dysfuntion of nerve system left, such as hemiplepsy, aphasia, et al; lcase(2.8%) had died. Conclusion Choosing right method to cure cAVM according to its Spetzler - Martin classification and clinic type can decrease deformity rate and mortality.