Risk Factors Of Early Neurological Outcome After Surgery For Cerebral Arteriovenous Malformation

Purpose: We sought to define risk factor of early neurological deficit after micriosurgery for brain arteriovenous malformations (AVMs). Methods: One hundred one retrospective patients (69.3% men, mean age 27.3 years) underwent microsurgical cerebral AVMs resection. They were classified according to the 5-point Spetzler-Martin grading system, with its 3 elements: size, venous drainage pattern, and location. Patients were examined by neurologists immediately before surgery and at discharge day. The functional neurological status was classified with the modified Rankin scale. Binary logistic regression models were applied to test the effect of patient gender,age, intracerebral haemorrhage, and the 3 Spetzler-Martin elements on early neurological complications.Chi-square test was applied to test the effect of Spetzler-Martin grade on early neurological complications. Results: Thirty five patients (34.7%) were classified as Spetzler-Martin grade I; 28 (27.7%) as grade II; 27 (26.7%) as grade III; 8(7.9%) as grade IV; and 3(3.0%) as grade V. Postoperatively, in-hospital, 29 patients (28.7%) showed new neurological deficits.AVMs deep venous drainge, eloquent location, size,and intracerebral heamorrhage significant association with new early neurological deficits; For patient gender, age, no significant association was found. The rate of neurological complications increased by Spetzler-Martin grade. Conclusions: The findings suggest that AVMs drainage into the deep venous system, eloquent location and size may be the risk factors of new early neurological deficit after microsurgical resection.The patients who presented with intracerebral heamorrhage had less new early neurological deficits than others who presented without intracerebral heamorrhage.Intracerebral heamorrhage may mask this surgical morbidity. The Spetzler-Martin grading system was a significant predictor of early neurological outcome. The higher the grade was,the more the early neurological complications were after microsurgical AVMs resection.