Surgical results in pediatric Spetzler-Martin grades I-III intracranial arteriovenous malformations

Abstract

Objects: The goal of cerebral arteriovenous malformation (AVM) therapy in pediatric patients should be complete resection or obliteration of the AVM to eliminate subsequent hemorrhage, because of high mortality and morbidity rates related to hemorrhage in addition to the longer life expectation. Despite advances in Gamma knife radiosurgery and in endovascular embolization, surgical resection is still the gold standard for treating cerebral AVMs. Methods: Between 1986 and 2003, 20 children were surgically treated for cerebral AVMs. The AVMs were graded I, II, and III using the Spetzler - Martin ( S - M) Grading Scale. Good recovery was achieved in 18 out of 20 patients ( 90%) and only 1 patient was moderately disabled (5%). There was one mortality ( 5%) related to the preoperative deep comatose state of the patient. The total obliteration rate was 89% ( 17 out of 19). Conclusion: For S - M grade I - III AVMs, surgical resection is the treatment of choice, considering its high cure rate and low morbidity and mortality rates.