target bp prior to obliteration of aneurysm

Manuscripts that described patients with nondisabling seizures or reduced seizure frequency in their seizure-free calculations were excluded. Included manuscripts were methodically scrutinized for quality, spontaneous AVM-associated or hemorrhage-associated seizures, complete seizure-free rates following each interventional treatment, follow-up duration determination methods of seizure outcomes, and average time-to-onset of recurrent seizures after each treatment. A systematic review of PubMed, Ovid MEDLINE, and Ovid EMBASE was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This systematic review and meta-analysis aims to assess the current evidence regarding complete seizure freedom rates following surgical resection, stereotactic radiosurgery (SRS), and/or endovascular embolization of intracranial AVMs. Seizures are common presenting symptoms of intracranial arteriovenous malformations (AVMs). Until safer methods exist to cure large AVMs the use of targeted embolization is acceptable as it protects patients against rehemorrhage and translates into an improvement in their clinical picture. Patients cured did best and targeted embolization improved seizures in nine patients, neurological deficit in four patients and headache in 20 patients. Results of targeted treatment showed a lower rehemorrhage rate than anticipated by the natural history. Targets identified included high flow fistulas (12), decreasing venous flow (17) and cure of the AVM (8). Other patients presented with headaches (2), neurological deficit (4) and seizures (16) with two patients having their AVM picked up coincidentally. In 22 of the patients who presented with a hemorrhage an intranidal aneurysm was identified as a target and treated in nine patients. Over a 36-month period 42 AVMs were treated. With this in mind we retrospectively reviewed our cohort of AVMs to establish which morphological areas we had identified as targets and how the treatment of the AVM influenced the clinical picture. Endovascular treatment, however, allows the possibility of partial treatment directed at specific areas of AVM architecture. This is certainly true if surgery or radiotherapy is used as the treatment strategy.

Although cure of cerebral arteriovenous malformations (AVMs) is the ideal goal it is often only possible with smaller sized lesions.

Target bp prior to obliteration of aneurysm