小脳未破裂動静脈奇形の治療戦略(<特集>未破裂脳動静脈奇形) Treatment Strategy for Non-ruptured Cerebellar Arteriovenous Malformations: Retrospective Analysis of 11 Cases(<Topics>Unruptured Arteriovenous Malformation)

We report a retrospective analysis of 11 cases of non-ruptured cerebellar arteriovenous malformations (AVMs) among 294 cases of intracranial AVMs between 1981 and 2004. Eight of 11 cases were surgically treated. Seven patients had good outcomes (modified Rankin scale 0-2) and 1 patient was dead because of brainstem dysfunction after the removal of a giant cerebellar AVM. Surgical treatment is indicated for symptomatic cases, particularly for pediatric cases and cases associated with intracranial aneurysms because of the high bleeding rate and poor outcome after the hemorrhage. However, surgical treatment is contraindicated for arteriovenous malformations that extend to the cerebellar peduncle or brainstem, particularly for giant cerebellar AVM because of the high morbidity and mortality rates.