Haseki Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, İstanbul

OBJECTIVES: Cerebral arteriovenous malformation (AVM) is a uncommon vascular disease in neurological science, and indication for alternative treatments remains controversial. This study presents a review of a series, to assess the importance of microsurgery of 42 consecutive patients with AVMs. MATERIAL and METHODS: This study was performed in two different neurosurgical center but, observed and done by same author (TB). Collected data of 42 consecutive patients with AVMs surgery from January 2000 to January 2006 were analyzed retrospectively. The variables assessed for clinical characteristics in our study included age, sex, synuptoms, preoperativepostoperative neurological status and Spetzler-Martin grade. RESULTS: All lesions were supratentorial and located in the frontal (40.5%), parietal (37.7%), occipital (19%) and pineal (4.8%) regions. Other pathologies were an arterial aneurysm in three cases and a venous aneurysm in one case. When the Spetzler-Martin grading system was used, there were 7 grade 1 (16.7%), 17 grade 2 (40.5%), 14 grade 3 (33.2%), 2 grade IV (4.8%) and 2 grade V (4.8%) cases. There were two important coplications as hemiparalysis (16.6%) and hemianopsia (2%). One patient died in the early postoperative period due to cerebral hemorrhage. The follow-up duration wes 1 month to 11 years with a mean value of 3.6±2.2 years. CONCLUSION: Cerebral AVMs may be treated by microsurgical resection, and this method is safer and may be best choice for appropriate patients. A complete and definitive microsurgical excision of an AVM can be achieved with high success rate and low morbidity-mortality rate. The Spetzler-Martin grading system is helpful to predict the surgical risk.