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Academia Mexicana de Neurología, A.C.

2010, Number 5

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Rev Mex Neuroci 2010; 11 (5)

Brain arteriovenous malformations: cohort study of 302 patients

Larios C, Mimenza AA, Zenteno M, Murillo-Bonilla L, Sánchez HJ, García RG, Cantú-Brito C

Language: Spanish
References: 25
Page: 330-337
PDF size: 161.70 Kb.


ABSTRACT

Introduction: There is a remarkable controvery regarding the appropriate management of brain arteriovenous malformations (AVMs) during the last decade. There are a few studies about brain AVMs in Latin-America. The aim of the current study is to determine the clinical features, management, and outcome of AVMs in Mexico. Patients and methods: Prospective observational study of 302 patients with diagnosis of brain AVM by neuroimaging, carried out in two reference centers in Mexico (Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez and Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán). In each patient the following data were obtained: demographics, clinical presentation, location and morphology of the AVMs, management, and long-term clinical outcome. Results: Brain ACMs were more common in men (57%) than women (43%) and involved mainly young people (65% had less than 35 years-old). Type III of Spetzler-Martin was the most common. Intracranial hemorrhagewas the most frequent clinical presentation (41%), mainly parenchyma located, followed by epilepsy and progressive neurological deficit. An invasive treatment was applied in 55% of cases (endovascular therapy or surgery). Long-term clinical outcome showed that 248 patients (82%) had good prognosis (Rankin 0-2), whereas 37 (12%) had severe disability, and death occurred in 17 patients (6%). Conclusions: This series of Mexicans patients with brain AVM showed a male predominance of young people, which often have longterm good clinical outcome. Case fatality rate was low (6%) and similar to other international series.


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