title: [Arteriovenous malformations of the brain: personal experience with 121 patients treated with microsurgery].
abstract: BACKGROUND
  Arteriovenous malformations (AVM) can be found in 0.1% of the population, and the most frequent presenting symptom is intracranial haemorrhage.
  
  
  OBJECTIVE
  To conduct a descriptive analysis of a series of cases of AVM that had been treated surgically by a neurosurgeon.
  
  
  METHODS
  The cases of AVM treated surgically by the author over the period 1990 to May 2014 were selected from a hospital register, and then the clinical, demographic and angiographic aspects were reviewed, together with the clinico-radiological findings six months after surgery.
  
  
  RESULTS
  Of the 400 patients treated over that same period, 121 were operated on by the author, their mean age being 34.3 years (range: 5-75 years). 61.7% of the patients were diagnosed due to a brain haemorrhage, and the second most frequent presenting symptom, in 19.8% of them, was because of epileptic seizures. A superficial supratentorial localisation, occurring in 97 cases (80.2%), was the most common. Over half the patients presented a low-grade AVM, I-II, according to the Spetzler and Martin scale. Twelve patients (10%) had associated non-intranidal aneurysms. In most cases, 109 (90.1%), elective surgery was performed. Complete resection of the AVM after the last angiographic examination was achieved in 118 patients (97.5%). The clinical results were good (good recovery and moderate disability) in 114 cases (95%), and poor (great disability and death), in six (5%).
  
  
  CONCLUSIONS
  Surgery is the best therapeutic option for many patients with AVM, if appropriate selection criteria are used.
authors.affiliation: Hospitals Vall d'Hebron, 08035 Barcelona, Espana.
authors.forename: Jordi
authors.initials: J
authors.lastname: Vilalta
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001925:Brain Damage, Chronic / Q000209:etiology; D002533:Cerebral Angiography; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D017558:Elective Surgical Procedures; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery; D011446:Prospective Studies; D012042:Registries; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult