Volume : VIII, Issue : I, January - 2019

EXPERIENCE WITH AVMs IN A PERIPHERAL TERTIARY CARE CENTRE

Dr. Mathiyash Arthur, Dr. C. Ramasamy

Abstract :

OBJECTIVES: Surgical management of AVMs has been proven to be challenging but play a definite and time–tested role in its treatment. Due to non–availability of procedures like embolization, radiosurgery and limited resources in a peripheral set up we rely on microsurgical management. We present a series of cases operated over a one year period and their follow–up. MATERIALS AND METHODS: To analyze the cases presented in our medical college in the last year from August 2017 to August 2018 and their outcome. A total of 7 cases underwent microsurgical excision of AVMs. The diagnosis of AVM was confirmed by DSA. RESULTS: There were 5 males and 2 female patients between the age groups of 38–60 years. Presentation included intracranial bleed in 5(71%), headache and seizures in 2(29%) patients. 4 AVMs involved the right hemisphere and 3 involved the left hemisphere. 2 cases involved frontal lobe, 2 involved temporal lobe, 1 parietal, 1 occipital and 1 multilobar with an associated aneurysm. On DSA 5 had less than 5cm nidus and 2 had more than 5cm. As per Spetzler and Martin: 1 was grade I, 3 were grade II and 3 were grade III. All the 7 patients underwent microsurgical excision and clipping as required. Complete surgical removal of the AVM was achieved as evidenced by follow up DSA in 6 patients, with significant symptomatic and clinical improvement. One patient deteriorated in the post op period and follow up DSA was not done. CONCLUSION: The microsurgical excision of AVMs is fraught with challenges. However if the patients are carefully selected, prepped and meticulous surgery is executed, it offers a single stage complete treatment with acceptable mortality and morbidity, especially in a resource crunched environment like ours.

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Article: Download PDF    DOI : https://www.doi.org/10.36106/paripex  

Cite This Article:

EXPERIENCE WITH AVMS IN A PERIPHERAL TERTIARY CARE CENTRE, Dr. Mathiyash Arthur, Dr. C. Ramasamy PARIPEX - INDIAN JOURNAL OF RESEARCH : Volume-8 | Issue-1 | January-2019


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