[A case of arteriovenous malformation, grade IV, with two giant aneurysms in dominant side speech and motor-senosry area--evaluation of grades, operability with microsurgical technique and pre- and post-operative performance status in 37 cases of cerebral vascular malformation (author's transl)].
A case of grade IV arteriovenous malformation(AVM) with 2 giant aneurysms, deeply seated in the dominant hemisphere speech and motor-sensory area, improved remarkably by a total excision, after an incapacitating rebleeding which occurred 4 months after a subtotal excision of the AVM. The author has learned importance of audacity on the part of the neurosurgeon. Personal experience of 37 CVM's (including 30 AV angiomas, 4 cryptic AVM's, and 3 other types of CVM's was analyzed. Of 37, 34 were operated on. Three were considered inoperable and were treated with radiotherapy (including proton beam). Of the 34 operated (30 AVM), 31 (24 AVM) were totally removed. None of them died or exhibitied deterioration. Of the 3 partially operated cases, one improved, two remained unchanged, but one of the two died of rebleeding 3 months later. Two of the radiated cases were later severely incapacitated due to rebleeding. One that underwent proton therapy is still under observation without deterioration after 18 months.
D000328:Adult; D001921:Brain / Q000601:surgery; D002533:Cerebral Angiography; D004292:Dominance, Cerebral; D005069:Evaluation Studies as Topic; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008866:Microsurgery; D009044:Motor Cortex / Q000601:surgery; D011184:Postoperative Period; D013003:Somatosensory Cortex / Q000601:surgery; D013064:Speech Disorders / Q000209:etiology; D014057:Tomography, X-Ray Computed