Cerebral arteriovenous malformation outcome
Hemorrhagic bAVMs have been shown to result in a morbidity rate of 30%-50% and mortality rate of 10%-30%[1]. Additionally, hemorrhagic bAVMs have a re-rupture risk of more than 4.8% per year 1) 2)
Epilepsy outcome in cerebral arteriovenous malformation
Size of the brain arteriovenous malformation is highly significant to seizure occurrence. Patients with cerebral hemorrhage are prone to having an acute seizure occurrence. Radiosurgery, embolization, and microsurgery could all influence seizure control and reduce the risk of rebleeding in pediatric bAVMs patients 3).
Radiosurgery provides reasonable rates of seizure improvement for patients with AVM who present with seizures 4). For patients with AVM without seizures at presentation, the risk of de novo seizures after radiosurgery is very low, obviating the need for prophylactic antiepileptic drug therapy. Further investigation of epilepsy in patients with AVM undergoing stereotactic radiosurgery should be considered with validated outcome measures and prospective study design 5).
Microsurgery led to the highest percentage of seizure-free outcomes and had the lowest annual bleeding rate, whereas radiosurgery had a higher bleeding rate. Median time to seizure-free status in surgically treated patients was shorter than in patients who underwent radiosurgical or endovascular treatment 6)