Clinical therapeutic analysis of cerebral arteriovenous malformation in the brainstem

Abstract

Objective To analyze and summarize the clinical therapeutic characteristics and efficacy of interventional embolization in cerebral arteriovenous malformation(AVM)in the brainstem. Methods A retrospective analysis was conducted on clinical data of 17 patients with cerebral AVM in the brainstem underwent principal interventional embolization and auxiliary gamma knife(GK)during the period from April 2000 to March 2015. According to the Spetzler-Martin grading, grade I was noted in 5 patients, grade II in 7, grade III in 3 and grade IV in two. Only interventional embolization was implemented in 8 patients; combination interventional embolization and GK was implemented in 9 patients. The treatment efficacy of them was analyzed. Results Postoperative DSA showed that in the 8 patients performed interventional embolization, one patient had 100% AVM disappearance, 5 had more than 2/3 AVM disappearance, and two had 1/3-2/3 AVM disappearance; in the 9 patients performed interventional embolization and GK, 6 patient had 100% AVM disappearance, one had more than 2/3 AVM disappearance, and two had 1/3-2/3 AVM disappearance. Follow up for two months to three years indicated that two had headache occasionally, 5 had neurological dysfunction which was severer than that before treatment, and 8 had good recovery without any nervous system positive signs. Conclusion The treatment for cerebral AVM in the brainstem is very knotty, but good therapeutic effect according to image characteristics can be achieved by adopting principal interventional embolization and auxiliary GK treatment. Key words: Brainstem; Cerebral arteriovenous malformation; Interventional embolization; Radiotherapy