title: Natural course of the arteriovenous malformations of the brain initially presented by hemorrhage: analysis of a clinical series of 39 patients.
abstract: OBJECTIVE
  AVM because of outstanding tendency toward bleeding, even though 20 times more rare then aneurysm on the blood vessels of the brain and her own specific anatomical structure even today represents big neurosurgical challenge.
  
  
  METHODS
  Series which is shown here consists of 39 patients which were hospitalized in the institute for neurosurgery of the Clinical Center of Serbia in the period between 1995 and 2004. This group was exposed to symptomatic therapy or it was estimated that surgery, embolization and radio surgery.
  
  
  RESULTS
  Combined type of venous drainage brings a high risk (p < 0.001) from repeated bleeding. Combined artery bringing from different flows (p < 0.05) contributes to genesis of 'steal phenomenon', in combination with deep venous drainage it presents predisposing anatomical characteristics for repeated bleeding (p < 0.001) according to our results should present AVM with dimensions 2.5 to 5 cm localized in eloquent zone of big brain with combined type of venous drainage and cobined artery bringing from vertebro-basilar flow and carotid flow.
  
  
  CONCLUSIONS
  Perception of natural course of AVM point to certainly more benign pathology in regard to other vascular malformations. Specific anatomical structure requires planning of treatment from case to case, most often combination of embolization, radio surgery and surgical treatment.
authors.affiliation: Clinical Centre of Serbia, Institute for Neurosurgery, Belgrade,Serbia, Yugoslavia.
authors.forename: Goran
authors.initials: G
authors.lastname: Tasic
authors.forename: Vladimir
authors.initials: V
authors.lastname: Jovanovic
authors.forename: Branko
authors.initials: B
authors.lastname: Djurovic
authors.forename: Igor
authors.initials: I
authors.lastname: Nikolic
authors.forename: Milos
authors.initials: M
authors.lastname: Janicijevic
authors.forename: Miroslav
authors.initials: M
authors.lastname: Samardzic
authors.forename: Vaso
authors.initials: V
authors.lastname: Antunovic
authors.forename: Vojislav
authors.initials: V
authors.lastname: Bogosavljevic
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001488:Basilar Artery / Q000502:physiology; D002339:Carotid Arteries / Q000502:physiology; D002536:Cerebral Arteries / Q000473:pathology / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000473:pathology / Q000601:surgery*; D002648:Child; D018450:Disease Progression; D004322:Drainage; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000473:pathology / Q000601:surgery*; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D016634:Radiosurgery; D012008:Recurrence; D012737:Sex Factors; D014711:Vertebral Artery / Q000502:physiology; D055815:Young Adult