Kozlovsky A. Diagnostics and treatment of arteriovenous malformations of the brain with epileptic clinical flow.

The results of complex clinical and instrumental diagnostics and surgical treatment of 112 patients with arteriovenous malformations (AVMs) of the brain hemispheres with epileptic attacks and their equivalents were analyzed. 87 (77.5%) patients were from 18 to 40 years old, 85 (75.9%) - suffered from epileptic attacks.AVMs, accompanied by epileptic attacks, were located mainly (in 28 (25%) cases) in frontal lobe, had wedge-shaped form with deep convexital diffusion (in 51 (45.5%)).All patients have been operated: transcranial extirpation was performed in 15 (13.4%) cases, endovascular embolization of AVM afferents and malformation itself - in 90 (80.4%), radiosurgery - in 1 (0.9%), combined treatment - in 6 (5.4%). In 60 (66.7%) from 90 patients, been operated using endovascular method, multi-stage embolization of AVM was performed. Total devascularization of AVMs of the brain with epileptic attacks was achieved in 23 (20.5%) cases, subtotal - in 40 (35.7%), partial - in 49 (43.8%).85 (75.9%) operations were not complicated, in postoperative period 5 (4.5%) patients had permanent neurologic disorders; there were no lethal cases.Improvement was marked in 90 (80.4%) cases, patient's state stabilization (without neurologic symptoms progression - in 17 (15.5%).