The Spetzler-Martin grading system and management of patients with intracranial Arteriovenous malformation in a tertiary referral hospital
Introduction: An arteriovenous malformation (AVM) is an abnormal collection of blood vessels in which arterial blood flows directly into the draining vein without the normal interposed capillaries. The Spetzler-Martin grading system has been widely accepted worldwide to estimate the pretreatment...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
2010
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| Online Access: | http://psasir.upm.edu.my/id/eprint/8094/ http://psasir.upm.edu.my/id/eprint/8094/1/Spetzler91-99%28edSP%29.pdf |
| Summary: | Introduction: An arteriovenous malformation (AVM) is an abnormal collection of blood
vessels in which arterial blood flows directly into the draining vein without the normal
interposed capillaries. The Spetzler-Martin grading system has been widely accepted
worldwide to estimate the pretreatment risks and predict the outcome of patients with
intracranial AVM. In Malaysia, we still do not have the baseline data of this grading
system. Methods: A total of 33 patients from a tertiary referral hospital diagnosed with
intracranial AVM based on neuroimaging findings over a 4-year period were studied. Medical
records were traced and neuroimaging findings were analysed. The AVMs were graded
according to the Spetzler-Martin grading system and Fisher’s exact test was used to assess
statistical difference between the grades of the AVM and management plan for the patients.
Results: Four patients were graded as Grade 1, 9 patients as Grade II, 10 patients as
Grade III, 6 patients as Grade IV and 4 patients as Grade V. Ten patients were treated
conservatively; six patients underwent surgery and embolisation respectively. Four patients
underwent radiosurgery and a combination of embolisation while surgery and radiosurgery
were given to 5 patients and 2 patients respectively. Statistically significant difference
(p=0.016) was found between the Spetzler-Martin grading system and the management of
intracranial AVMs. Conclusion: The management decision was not made based on the
grading of the AVMs. It is recommended that all AVM patients be routinely graded according
to this system prior to treatment.
Keywords: Intracranial arteriovenous malformation, |
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