Surgical Versus Conservative Treatment of Intracranial Arteriovenous Malformations

A Study in Surgical Decision-Making

  • Luigi Pellettieri

Part of the Acta Neurochirurgica book series (NEUROCHIRURGICA, volume 29)

Table of contents

  1. Front Matter
    Pages I-VIII
  2. Luigi Pellettieri
    Pages 1-5
  3. Luigi Pellettieri, Christer Uhlemann
    Pages 6-28
  4. Luigi Pellettieri
    Pages 29-35
  5. Luigi Pellettieri, Carl-Axel Carlsson
    Pages 36-54
  6. Luigi Pellettieri, Carl-Axel Carlsson, Gösta Norlén
    Pages 55-70
  7. Luigi Pellettieri, Carl-Axel Carlsson, Sven Grevsten
    Pages 71-79
  8. Luigi Pellettieri
    Pages 80-83
  9. Back Matter
    Pages 84-86

About this book

Introduction

The main aim of this study is to define the clinical criteria which must be considered in order to come to an adequate decision whether a patient with intracranial arteriovenous malformation (AVM) should be operated upon or treated conservatively. A special method was used to reduce the effects of selection. This method made it possible to evaluate the therapeutic efficacy of conservative treatment versus surgery. The method implies that patients with equal combinations of variables (risk profiles) were compared in the two treatment lines. The variables building up the risk-profile pattern were chosen by analysing the decision process, as it was originally practiced by the surgeon who selected and treated the patients of this study. The risk profiles thus described relevant characteristics of the patient and his malformation. The variables were assigned numerical values accord­ ing to their prognostic value. Summation of the variables making up the risk profile then gives each risk profile a certain value. A low value symbolizes a bad prognosis and a high value a good prognosis in both treatment groups. There were many risk profiles with the same value in both groups and a comparison could be made over a large part of the risk-profile scale. This comparison showed that surgical treatment of A VM can always be justified, although the indications for surgery are less strong in patients with low risk­ profile values.

Keywords

Gefässchirurgie Gefässmissbildung Hirnchirurgie assessment classification mortality outcome patients relationships sex surgery treatment

Authors and affiliations

  • Luigi Pellettieri
    • 1
  1. 1.Department of Neurosurgery, Akademiska SjukhusetUniversity of UppsalaUppsalaSweden

Bibliographic information

  • DOI https://doi.org/10.1007/978-3-7091-8567-4
  • Copyright Information Springer-Verlag Vienna 1980
  • Publisher Name Springer, Vienna
  • eBook Packages Springer Book Archive
  • Print ISBN 978-3-211-81561-8
  • Online ISBN 978-3-7091-8567-4
  • Series Print ISSN 0065-1419
  • About this book