Surgical treatment of ruptured cerebellar arteriovenous malformations

Abstract

To analyze the clinical characteristics and surgical outcomes of ruptured cerebellar arteriovenous malformations (AVM). The clinical data were retrospectively analyzed for 676 brain AVM patients. Among them, 616 cases were treated at Beijing Tiantan Hospital from January 2003 to December 2009 and 32 cases of them were of cerebellar AVM. Another 60 cases of intracranial AVM were managed at Beijing Chaoyang Hospital from January 2003 to December 2011 and there were 8 cases of cerebellar AVM. Microsurgery was performed to remove hematoma and excise AVM. And the postoperative outcomes were evaluated. Statistics analysis of activities of daily living (ADL) scores for 636 cases of cerebral AVM and 40 cases of cerebellar AVM showed no significant difference. Among 40 cases of cerebellar AVM, hemorrhage occurred first in 35 (87.5%) patients. Postoperative re-examinations of computed tomography revealed the resolution of hematoma and the absence of re-hemorrhage. Digital subtraction angiography (DSA) examinations were performed in 39 cases and no residual nidus was observed. Tonsillar herniation occurred preoperatively in 1 case and DSA was not re-examined. There were balance dysfunction (n = 3), dysarthria (n = 2) and dystaxia and dysphasia (n = 1). The postoperative ADL degrees were I(n = 26), II(n = 10), III(n = 3) and IV(n = 1). During a follow-up period of 6 months, no re-hemorrhage occurred and there was no worsening function of central nerve system. Emergency microsurgery is effective in the treatment of ruptured cerebellar AVM.