Multidisciplinary Approach for the Management of Brain Arteriovenous Malformations

  • BABAR BUTT Assistant Professor Neurosurgery Punjab Institute of Neurosciences, Lahore General Hospital, Lahore
  • MOHAMMED SAEED BIN MAHFOODH Consultant Neurosurgeon, Department of Neurosciences, King Faisal Specialist Hospital and Research Center Jeddah, K.S.A
  • SALEH SALEM BAEESA Consultant Neurosurgeon, Department of Neurosciences, King Faisal Specialist Hospital and Research Center Jeddah, K.S.A
  • KHALIL IBRAHIM KURDI Consultant Interventionist & Neuroradiologist-Department of Neurosciences, King Faisal Specialist Hospital and Research Center Jeddah, K.S.A
  • MUHAMMAD KHALID Assistant Consultant Neurosurgeon-Department of Neurosciences, King Faisal Specialist Hospital and Research Center Jeddah,
Keywords: Arteriovenous malformation, Embolization of AVM, Radiosurgery of AVM, Microsurgical resection of AVM

Abstract

Objective: The main Objective of this study was to evaluate the significance of multimodality treatment of AVMs.
Material and Methods: The data for this study was collected from the four years audit of surgical management of Arterio-venous Malformation in King Faisal Specialist Hospital and research center Jeddah, from year 2014 to 2017 which include 24 patients with brain AVMs.
Results: In our study equal no. of male and female patients were recorded i.e. 12 patients in each group (50.00%). Seventeen (70.83%) patients were found in the first three decades of life indicating that the disease affects the younger age group. Main presenting complaint was seizures that was noted in 16 patient (66.66%) while headache was present in 15 patients (62.50%) followed by other signs and symptoms. Treatment of the patient was tailored according to the type of AVM its grade and the best possible way to take the complex disease. It included combination of pre-surgical or post-operative embolization, Complete of partial surgical resection of the lesion and stereotactic radiosurgery. The combination of these modalities were employed according to the situation of the patient to keep the plan of treatment safe, affective and ending finally in exclusion of the disease from the brain circulation. Pre-surgical embolization was successfully done in 7(29.16%) patients wile surgical resection was done in all patients at different stages of treatment. With use of multidisplanary approach in this series; Improvement was seen in 16 (66.66%) of the patient, 6 (25.00%) revealed no improvement while one patient (04.16%) was deteriorated.
Conclusion: It was concluded that tailoring the treatment plan and use of multidisciplinary Approach for the management of Brain AVM depending upon their initial grades according to Spetrelz Martin grading system results in maximum favorable results.

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Published
2018-11-08