Microsurgery for ruptured cerebellar arteriovenous malformations

S.-F. Gong, X.-B. Wang, Y.-Q. Liao, T.-P. Jiang, J.-B. He, X.-J. Wang, J.-J. Ding, Y.-Z. Gao, W.-P. Li

The First Affiliated Hospital of Shenzhen University, Shenzhen, P.R. China. jtpptj@163.com

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• Neurology

OBJECTIVE: To summarize the clinical features of ruptured cerebellar arteriovenous malformations (AVMs) and to explore surgical methods and outcomes in ruptured cerebellar AVM patients.

PATIENTS AND METHODS: In the past 14 years, 67 patients with cerebellar AVMs were treated at our institution, accounting for 14.9% of the total vascular malformation patients in our department. In this study, we retrospectively analyzed the clinical characteristics, operation indication, surgery techniques, and prognoses of these cases.

RESULTS: Among the 67 AVM cases, the distribution of Spetzler-Martin grades was 32 Grade I, 14 Grade II, 13 Grade III, 5 Grade IV, and 3 Grade V cases. Microsurgical treatment was carried out via the retrosigmoid approach or suboccipital midline approach. After the surgery, the distribution of GOS grades was 60 Grade V, 3 Grade IV, 1 Grade III, 2 Grade II, and 2 Grade I cases.

CONCLUSIONS: Microsurgical removal should be performed in ruptured cerebellar AVM patients as early as possible once the preoperative and postoperative preparations were done. Good surgical effects were obtained by using proper surgery techniques and the right protection of critical cerebral structures. Patients with a GCS grade of ≥ 8 showed good recovery, but patients with a grade of < 8 had poor prognoses.

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