Premiers signes cliniques et résultats de l'exérèse chirurgicale des malformations artérioveineuses cérébrales

On the basis of 90 cerebral AVMs, the authors study clinical signs which show the AVM, before a dramatic bleeding. Such clinical signs are: benign subarachnoid hemorrhage or intracranial hypertension and, only for lobar AVMs, migraine, epileptic seizures, progressive neurological deficit. In such cases a misdiagnosis is avoided by CT Scan with contrast. In the second part, the authors show that the AVMs surgical removal gives better results than AVMs natural history studied over a 20 years period. Ten AVMs observed in deep coma died. Two surgical deaths are only observed out of 73 AVMs surgical removals. Out of 44 lobar AVMs totally removed, 37 show good results and seven disabilities. Out of 19 deep AVMs, 13 were totally removed and six partially. Such deep AVMs, especially AVMs of the corpus callosum or of lateral and third ventricles choroid plexus give excellent surgical results. The authors conclude that surgical removal is the safer treatment for the majority of AVMs (Acta neurol. belg., 1985, 85, 65-81).