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Seizures and Brain Arterovenous Malformation: A Surgical Series

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Trends in Cerebrovascular Surgery

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 123))

Abstract

Seizures are common symptoms of supratentorial arteriovenous malformations (AVMs). The potential risk factors for epilepsy in patients with AVMs are still controversial. The reported long-term outcome of seizures after surgical treatment of AVMs is variable and the data available are mainly from small retrospective case series.

We identified all consecutive patients between 1990 and 2006 who underwent microsurgical resection of supratentorial AVMs at our institute. Pre-operative risk factors for seizures, intra-operative characteristics, long-term neurological disability, and seizure outcome (Engel’s classification) were recorded and analyzed.

During the study period, 110 patients underwent surgical resection of supratentorial AVM. Sixty of them (55 %) were symptomatic for seizures preoperatively. In our series, the absence of preoperative neurological deficits (p = 0.005), a large AVM size (p = 0.005), and no history of preoperative AVM hemorrhage (p < 0.001) were identified as risk factors for preoperative seizures. Following surgical resection, 77 % of patients with preoperative seizures had a modified Engel class I outcome. Among patients without a history of preoperative epilepsy, 56 % had new-onset seizures after surgical resection. None of the risk factors associated with preoperative seizures was associated with post-operative seizures. As there are no reliable factors predicting patients who may benefit from surgical treatment, epilepsy control should not be considered as the primary goal of AVMs surgery.

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Authors and Affiliations

  1. Division of Neurology “A”, University Hospital of Verona, p.le Stefani 1, Verona, 37126, Italy

    M. Ferlisi MD, T. Zanoni MD & G. Moretto MD

  2. Section of Vascular Neurosurgery, Institute of Neurosurgery, University Hospital of Verona, p.le Stefani 1, Verona, 37126, Italy

    A. Pasqualin MD

Authors
  1. M. Ferlisi MD
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  2. T. Zanoni MD
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  3. G. Moretto MD
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  4. A. Pasqualin MD
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Corresponding author

Correspondence to A. Pasqualin MD .

Editor information

Editors and Affiliations

  1. Kyoto Medical Center, National Hospital Organization, Fukakusa, Fushimi-ku, Kyoto, Japan

    Tetsuya Tsukahara

  2. Institute of Neurosurgery, Verona City Hospital, Verona, Italy

    Alberto Pasqualin

  3. Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland

    Giuseppe Esposito

  4. Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland

    Luca Regli

  5. Institute of Neurosurgery, Verona City Hospital, Verona, Italy

    Giampietro Pinna

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Ferlisi, M., Zanoni, T., Moretto, G., Pasqualin, A. (2016). Seizures and Brain Arterovenous Malformation: A Surgical Series. In: Tsukahara, T., Pasqualin, A., Esposito, G., Regli, L., Pinna, G. (eds) Trends in Cerebrovascular Surgery. Acta Neurochirurgica Supplement, vol 123. Springer, Cham. https://doi.org/10.1007/978-3-319-29887-0_21

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  • DOI: https://doi.org/10.1007/978-3-319-29887-0_21

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29885-6

  • Online ISBN: 978-3-319-29887-0

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