Prognostic Factors In The Neurosurgical Treatment Of Cerebral Arteriovenous Malformations

Purpose Arteriovenous Malformations (AVMs) of the brain are highly vascularized lesions representing a surgical challenge. This study aims to test whether certain clinical and paraclinical aspects of AVMs contribute to the general outcome of patients undergoing neurosurgical treatment. Materials And Methods A one-center one-surgeon retrospective study is performed in a 10-year interval, on 106 patients harboring symptomatic AVMs. Examined parameters are condensed into an original grading scale. Statistical analysis is performed using the "F test" and Pearson/Spearman coefficient to verify the causality between each of these parameters with the Glasgow Outcome Score (GOS). Results Patients' mean age is 37.26 years, with a standard deviation of 16.49 years and a 95% confidence interval of 37.26 +/- 3.34 years. Male-to-female ratio is 1.12. Linear inverse-proportional low-intensity relationships between GOS and age (r=-0.223, p =0.021), presenting symptom (r=-0.287, p=0.003), and venous drainage (r=-0.199, p=0.041) are obtained. Linear inverse-proportional correlations of moderate intensity are observed between GOS and state of consciousness upon admission (r=-0.490, p=0.000), and hemorrhage volume (r=-0.342, p=0.000). No relationships between GOS and the other parameters studied are noticed. Conclusion The Spetzler-Martin grading scale remains a valid prognostic tool in the outcome of surgically treated cerebral AVMs. However, since resection of these lesions remains the only definitive curative option, new prognostic factors should be determined. Our study demonstrates that there is a correlation between patient outcome and neurological status upon admission, hemorrhage volume, as well as the presenting symptom and venous drainage of AVMs.