Objective: The purpose of this study is to assess demographic, clinical, and morphological characteristics
of patients with brain arteriovenous malformations (bAVMs). The relation of outcome
using modified Ranklin Scale (mRS) at time of discharge, early and last follow ups
with respect to various factors. Materials and Methods: Demographic data, arteriovenous malformation characteristics, and treatment outcomes
were evaluated in 43 bAVMs treated with microsurgery between 2009 and 2019. For this
series, 43 patients were retrospectively reviewed. A subgroup analysis for Spetzler-Martin
grades (SMG) I/II, III, IV/V and III–V were performed. The mRS was used to assess
functional outcomes. Results: Overall, mean age at diagnosis was 33 years (standard deviation = 19). Transient
deficit, mRS deterioration and impaired functional outcome occurred less frequently
in SMG I–II patients compared with Grade III–V patients combined (29% vs. 32% respectively,
P = 0.00). All patients with SMG Grade I, Supplemented SMG Grade 2, 3, 4 and 6 had
a mRS score of 2 or less at the last follow-up. Age was the only significant predictor
of overall outcome after bAVM surgery on Chi-square test (P = 0.046), i.e: all patients
<20 years had mRS score of 2 or less on last follow-up. Unfavorable outcome (mRS score
of 3 or more than 3) level increased with higher grades in SMG on long term follow-up.
Conclusion: The results of our case series of bAVM with SMG Grade I and Suplemented Grade 2,
3, 4 and even higher grade i.e., 6 can have excellent overall outcome after microsurgical
resection. Association of factors which increases the grading system of bAVM like
eloquence, deep venous drainage and increasing sizes did not correlate with the predicted
unfavorable outcomes, whereas age of patients was a predictor of overall outcome.
Although the small sample size of this study is a limitation, age of patient plays
important role on the overall outcome.
Key-words:
Arteriovenous malformations - brain arteriovenous malformation - functional outcome
- microsurgery - Spetzler-Martin grades
