The Surgical Management of Cerebral Arteriovenous Malformations: A Retrospective Analysis of Outcomes and Complications

This study aimed to investigate the surgical management of cerebral arteriovenous malformations (AVMs) by analyzing clinical outcomes and complications in 600 patients (100%) who underwent surgery. The mean age of the cohort was 36.7 years (SD = 12.3), with a majority being female (n = 315, 52.5%). Patients were classified by AVM size: small (35.5%, n = 213), medium (31.5%, n = 189), and large (33%, n = 198). Surgical approaches included microsurgery (31.3%, n = 188), endovascular embolization (33.5%, n = 201), and radiosurgery (35.2%, n = 211). Surgical outcomes revealed that 33.8% (n = 203) achieved complete resection, 32.7% (n = 196) had partial resection, and 33.5% (n = 201) underwent no resection. Post-surgical complications were experienced by 51.5% (n = 309) of patients, with the most common being postoperative hemorrhage (15.2%, n = 91), infection (14.8%, n = 89), and seizures (9.8%, n = 59). Logistic regression identified AVM size (OR = 2.3, p = 0.01), hypertension (OR = 1.8, p = 0.03), and seizure history (OR = 1.7, p = 0.04) as significant predictors of complications. Kaplan-Meier analysis revealed that patients with complete resection had the highest one-year recovery rate (78%), compared to partial (48%) and no resection (38%). Hospital stay was significantly longer for large AVMs (mean = 18.5 days) versus small AVMs (mean = 12.3 days; p = 0.001). These findings underscore the importance of AVM size and patient comorbidities in predicting surgical outcomes and complications, highlighting the need for tailored treatment approaches.