Microsurgical Resection Of Intracranial Arteriovenous Malformation:a Rather Tough Decision

Objective:Treatment modalities of intracranial arteriovenous malformations (AVMs) include observation, microsurgery, embolization, radiosurgery and multimodality treatment consisting of embolization followed by microsurgery or radiosurgery. We evaluate the role of Spetzler-Martin grading system in our decision making for microsurgical resection of intracranial AVMs in No2XiangYa hospital, Hunan province in China.Methods:According to pre-determined criteria, we retrospectively selected106patients successfully treated in our institution between September2009and December2011. There were69males and37females.48patients were treated with microsurgery resection,17patients with observation,31patients with embolization,8patients with radiosurgery,2patients with combined treatment. We determine whether Spetzler-Martin grading system influences our decision making for treatment.Results:At presentation Spetzler-Martin grading score was II for9patients, â…¢ for47patients, â…£ for41patients and V for9patients. Their presenting symptoms include headache (24.53%), hemorrhage (49.06%), seizures (11.32%), neurological deficits (10.38%), vertigo (1.88%) and incidental findings (2.83%). Age, sex and Glasgow coma score on admission were not statistically significant in predicting our decision for microsurgical resection over other treatment modality whereas Spetzler-Martin grade on admission was statistically significant in predicting our decision for microsurgery excision modality.Conclusion:Spetzler-Martin grading system is an efficient predictor in our decision making for microsurgery resection of intracranial arteriovenous malformations. The decision becomes tough though when confronted with grades â…¢ or â…£ intracranial AVMs.