Clinical outcome of radiosurgery, embolization and microsurgery for AVMs in the thalamus and basal ganglia.
Ninety-six cases of arteriovenous malformation (AVM) in the basal ganglia and thalamus were retrospectively analyzed. The prognosis of patients presenting with hemorrhage was poor, if conservatively treated. The mortality and morbidity were 62.5% and 12.5%, respectively. In the surgically resected group, 10 (66.6%) out of 15 patients are working and 4 patients (26.7%) are independent. Only one patient, who had a hypertensive intracerebral hemorrhage during rehabilitation, is bed-ridden. As to the final outcome of 60 cases treated with the gamma knife, 39 patients (65%) are working, 11 patients (18.3%) are independent and 4 patients (6.7%) are dependent. Comparing the treatment results between pre- and post-gamma knife era, extirpation rate, morbidity and mortality were 44.8%, 20.7% and 20.7% in the pre-gamma-knife era, while those in the post-gamma-knife era were 80.0%, 10.4% and 1.5%, respectively. Thus, the final outcome has undoubtedly improved after the introduction of the gamma-knife.
Sasaki
T
T
Department of Neurosurgery, The University of Tokyo, Tokyo, Japan.
Kurita
H
H
Kawamoto
S
S
Nemoto
S
S
Kirino
T
T
Saito
I
I