Surgical treatment of pericentral arteriovenous malformation

Surgical treatment of pericentral arteriovenous malformation (AVM) near the central sulcus is discussed. Thirty-four patients with pericentral AVM were treated and they can be classified into four subtypes: operculofrontal AVM (nine cases); dorsolateral AVM (nine cases); parasagittal AVM (11 cases); and giant AVM involving sensorimotor cortices (five cases). In all surgically treated patients with operculofrontal AVM or dorsolateral AVM, nidi were totally removed and permanent morbidity was 6%. On the other hand, complete obliteration was usually difficult for parasagittal AVMs. Among six patients with surgically-treated parasagittal AVM, transient paralysis was found in three (50%) and permanent morbidity was observed in one (17%). Among four patients with parasagittal AVM who were treated by embolization therapy alone, transient paralysis was found in three (75%) and permanent morbidity was recognized in two cases (50%).