title: Treatment of unruptured arteriovenous malformations in the brain.
abstract: Clinical features and treatment results of 33 patients with unruptured arteriovenous malformations (AVMs) were evaluated. Nine AVMs were located in the frontal lobe, 8 in the motor cortex, 5 in the parietal lobe, 6 in the temporal lobe, 2 in the occipital lobe and 3 in other parts of the brain. Nine patients were treated with microsurgery and 24 with radiosurgery. Total extirpation of the AVM was performed in all 9 microsurgery patients. One patient with an AVM in the motor cortex experienced upper extremity weakness postoperatively. Eleven of 24 patients treated with radiosurgery had follow-up imaging studies. Obliteration was obtained in 8 patients and decreased size in 3. Complications included 1 patient with a hemiparesis and 1 with an AVM rupture prior to obliteration. The remaining 13 patients did not experience any complications over a mean period of 21.2 months. Microsurgery appears to be the best treatment for unruptured AVMs in non-eloquent areas. Radiosurgery is a safe, effective treatment for unruptured AVMs in eloquent areas, although a bleeding risk remains during the latency period prior to obliteration.
authors.affiliation: Department of Neurosurgery, Gunma University School of Medicine, Maebashi, Japan.
authors.forename: H K
authors.initials: HK
authors.lastname: Inoue
authors.forename: M
authors.initials: M
authors.lastname: Negishi
authors.forename: M
authors.initials: M
authors.lastname: Hirato
authors.forename: C
authors.initials: C
authors.lastname: Ohye