关键词: 脑动静脉畸形, 老年患者, 手术治疗

Abstract: Objective To analyze clinical features and treatment strategy of brain arteriovenous malformations(AVMs) in elderly patients(age≥60 y). Methods A retrospective survey of 25 cases of brain AVMs in elderly patients diagnosed from March 1997 to September 2008 in Beijing Tiantan Hospital was undertaken. The clinical features, treatment and outcomes were analyzed along with a systematic review of literature. The median follow-up period was 50 months(4~120 months). Results In this series the median age of patients was 65.2 years; the male: female ratio was 2.6∶1; the most common primary symptoms was intracranial hemorrhage(68.0%). Seven cases were treated conservatively when diagnosed, of whom hemorrhage at AVMs or recurrent hemorrhage occurred in 4 patients (57.1%) during the follow-up; 7 patients selected stereotactic radiosurgery, after radiosurgery hemorrhage at AVMs occurred in 3(42.9%); 5 patients were treated with endovascular embolization of feeding arteries of AVMs, in 2(40%) the arteries were embolized completely, of whom 1 died due to cerebral infarction after embolism, the other 3 were embolized partially; 11 patients took microneurosurgical resection, 2 died because of postoperative hemorrhage and cerebral infarction respectively , others achieved satisfactory outcomes. Conclusion Elderly patients with brain arteriovenous malformations had a high incidence of hemorrhage compared with younger ones. Microneurosurgerical removal of AVMs can achieve satisfactory postoperative outcomes. Age itself is not a limiting factor for the surgical excision of AVMs.

Key words: brain arteriovenous malformations, elderly patients, microneurosurgery