Treatment decision for occipital arteriovenous malformations (AVMs) to achieve hemorrhagic control while maximizing visual preservation: Our experience and review of literature

Publication date: Available online 4 November 2017 Source:Journal of Clinical Neuroscience Author(s): Wuyang Yang, Jose L. Porras, Eunice Philadelphia, Jody Law, Tomas Garzon-Muvdi, Justin M. Caplan, Geoffrey P. Colby, Alexander L. Coon, Rafael J. Tamargo, Judy Huang Despite concern of hemorrhagic risk, patients with occipital AVMs are at significant risk for visual disturbances after treatment. We aim to characterize the hemorrhage risk and visual disturbance in occipital AVMs patients from our experience and literature review. We performed retrospective review of occipital AVM patients seen at our institution from 1990 to 2015. Patient characteristics were compared using multivariable logistic regression with follow-up visual disturbance as the outcome. We also systematically reviewed the PubMed database for English literature describing occipital AVMs (with exclusion of case reports). Ninety-seven patients satisfied inclusion criteria for our study. Mean age was 34.9 ± 16.4 years, with 50.5% male. Thirty-one (32.0%) presented with hemorrhage, and 32 (33.0%) presented with visual disturbance. Average AVM size was 4.0 ± 2.5 cm. Twenty-five (25.8%) were conservatively managed, 13 (13.4%) underwent surgery, and the rest were managed by radiosurgery (52.6%) or embolization (8.2%), with an obliteration rate of 38.9% in treated patients. During average follow-up of 5.4 years, 6 patients (6.7%) hemorrhaged yielding an annual hemorrhage rate of 1.2% for ...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research