Author/Editor     Dolenc, VV; Pregelj, R; Šušteršič, J; Broaddus, WC
Title     Surgical treatment of cerebral arteriovenous malformations and epilepsy
Type     članek
Source     Med Razgl
Vol. and No.     Letnik 32, št. 1
Publication year     1993
Volume     str. 147-53
Language     eng
Abstract     A series of 267 consecutive patients with arteriovenous malformations (AVMs) surgically treated from 1975 through 1992 is presented. 214 patients were admitted to the Nurological Departments for diagnostic work-up because of headache and/or epileptic seizures. The remaining 43 patients were hospitalized because of neurological deficits which resulted from the lesion itself, or from hematoma due to rupture of the AVM. All patients were treated by direct microsurgical resection; in 240 patients the lesion was excised completely, whereas in 27 patients the lesion was partially removed. Most of the patients in whom the lesion was excised completely underwent a single operation, while several patients with a residual lesion were staged for additional resections. Two patients died after surgery due to rebleeding because the lesion was not completely removed. All the patients presenting with headache were symptom-free after surgery and antiepileptic treatment was necessary only in 8 of those patients due to irregular EEG findings. Among 76 patients with epilepsy before surgery, 15 (20 percent) did not need antiepileptic treatment after surgery, whereas in the remaining 51 patients of this group, epileptic seizures were controlled with much lower doses of antiepileptic drugs than preoperatively. Antiepileptic treatment was withdrawn only in cases where EEG following the surgical procedures was within normal limits. Twenty-two patients with preoperative neurological deficits retained their deficits following surgery, but the remaining 21 showed significant improvements in their neurological deficits post-operatively. All patients with preoperative neurological deficits were maintained on antiepileptic treatment for at least two years after surgery regardless of whether they had seizures in the pre-or post-operative periods. Anticonvulsants were subsequently discontinued if the EEG was within normal limits.(trunc.)
Descriptors     EPILEPSY
CEREBRAL ARTERIOVENOUS MALFORMATIONS
TREATMENT OUTCOME
RADIOSURGERY