Ruptured cerebral arteriovenous malformations: ...
Document type :
Compte-rendu et recension critique d'ouvrage
Title :
Ruptured cerebral arteriovenous malformations: outcomes analysis after microsurgery
Author(s) :
Aboukais, Rabih [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Marinho, Paulo [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Bourgeois, Philippe [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Leclerc, Xavier [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Vinchon, Matthieu [Auteur]
Maladies RAres du DEveloppement embryonnaire et du MEtabolisme : du Phénotype au Génotype et à la Fonction - ULR 7364 [RADEME]
Lejeune, Jean-Paul [Auteur]
Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 [OncoThAI]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Marinho, Paulo [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Bourgeois, Philippe [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Leclerc, Xavier [Auteur]

Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Vinchon, Matthieu [Auteur]

Maladies RAres du DEveloppement embryonnaire et du MEtabolisme : du Phénotype au Génotype et à la Fonction - ULR 7364 [RADEME]
Lejeune, Jean-Paul [Auteur]

Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 [OncoThAI]
Journal title :
Clinical Neurology and Neurosurgery
Clinical Neurology and Neurosurgery
Clinical Neurology and Neurosurgery
Pages :
137-142
Publisher :
Elsevier
Publication date :
2015-11-01
ISSN :
0303-8467
English keyword(s) :
Remnant
Nidus
AVM
Aneurysm
Outcome
Nidus
AVM
Aneurysm
Outcome
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
OBJECTIVE: Our study aimed to evaluate the functional outcome and the risk of postoperative remnant in patients with rAVM after microsurgical treatment.METHODS: This is a retrospective of 139 consecutive patients operated ...
Show more >OBJECTIVE: Our study aimed to evaluate the functional outcome and the risk of postoperative remnant in patients with rAVM after microsurgical treatment.METHODS: This is a retrospective of 139 consecutive patients operated for a rAVM between 2002 and 2012 in our institution. The age at diagnosis and the WFNS score were recorded for each patient before treatment. All patients were re-evaluated 3 months after treatment using mRS scale. Conventional angiography was performed in the first 2 postoperative weeks and then a year later to detect any remnant or recurrence.RESULTS: The mean age at diagnosis was 30.8 years (range 4-69 SD: ±5) and 44 patients had an age at diagnosis <18 yo. The mRS score 3 months after treatment was ≤2 in 104 patients (83%). Predictive factors of good functional outcome were age at diagnosis <25 yo, initial WFNS score ≤ 2, SPM grade ≤ 2 and absence of acute hydrocephalus (p<0.05). Complete obliteration was obtained in 123 patients (89.5%) after the first microsurgical treatment. Early postoperative conventional angiography revealed a rAVM remnant in 16 patients (10.5%). Late conventional angiography showed a recurrence in 6 patients (4.5%). All of them were <18 yo. Predictive factors of postoperative rAVM remnant were an initial WFNS score>2, SPM grade>2 and preoperative evaluation limited only to CT angiography in emergency situation (p<0.05).CONCLUSIONS: Functional outcome after microsurgical treatment was good in 83% of patients with rAVM. Good results were also recorded in 28% of patients with poor initial neurological status and severe intracerebral hemorrhage, which required immediate surgery. In case of remnant, a further treatment should be decided in a true multidisciplinary discussion to protect the patient from any rebleeding.Show less >
Show more >OBJECTIVE: Our study aimed to evaluate the functional outcome and the risk of postoperative remnant in patients with rAVM after microsurgical treatment.METHODS: This is a retrospective of 139 consecutive patients operated for a rAVM between 2002 and 2012 in our institution. The age at diagnosis and the WFNS score were recorded for each patient before treatment. All patients were re-evaluated 3 months after treatment using mRS scale. Conventional angiography was performed in the first 2 postoperative weeks and then a year later to detect any remnant or recurrence.RESULTS: The mean age at diagnosis was 30.8 years (range 4-69 SD: ±5) and 44 patients had an age at diagnosis <18 yo. The mRS score 3 months after treatment was ≤2 in 104 patients (83%). Predictive factors of good functional outcome were age at diagnosis <25 yo, initial WFNS score ≤ 2, SPM grade ≤ 2 and absence of acute hydrocephalus (p<0.05). Complete obliteration was obtained in 123 patients (89.5%) after the first microsurgical treatment. Early postoperative conventional angiography revealed a rAVM remnant in 16 patients (10.5%). Late conventional angiography showed a recurrence in 6 patients (4.5%). All of them were <18 yo. Predictive factors of postoperative rAVM remnant were an initial WFNS score>2, SPM grade>2 and preoperative evaluation limited only to CT angiography in emergency situation (p<0.05).CONCLUSIONS: Functional outcome after microsurgical treatment was good in 83% of patients with rAVM. Good results were also recorded in 28% of patients with poor initial neurological status and severe intracerebral hemorrhage, which required immediate surgery. In case of remnant, a further treatment should be decided in a true multidisciplinary discussion to protect the patient from any rebleeding.Show less >
Language :
Anglais
Popular science :
Non
Source :