59. 脳動静脈奇形に関する研究 (I):-手術成績, 特に保存的療法との対比から-

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The purpose of this study is to clarify the surgical indication for intracerebral arteriovenous malformation (AVM) based on retrospective study. <BR>The case records of 150 patients with cerebral AVMs who were admitted to the Department of Neurosurgery, Tokyo Women's Medical College (TWMC) between 1969 and 1984 were reviewed. The clinical manifestation was mostly related to hemorrhage and less frequently to epilepsy or to a cerebral steal syndrome, and the risk of hemorrhage in AVMs tended toward small, deep-seated lesions and infratentorial lesions. <BR>Eighty malformations were completely excised, in nine patients only a partial excision could be carried out, in eight occlusion of feeding vessels was done and 53 cases were followed without surgery for from six months to 29 years. <BR>Good results were obtained in the 80 patients treated with total excision, operative mortality was 3.7% and total mortality 8. 8%. Results of partial excision were variable, in two cases, death occurred after another hemorrhage and six patients had a good outcome. Forty-six of the 53 nonsurgical patients received conservative medical treatment. The duration of follow-up ranged from six months to 26 years. Forty-two cases (91. 3%) had a satisfactry outcome and in two cases, death occurred after another hemorrhage.
The Japanese Society on Surgery for Cerebral Strokeの論文