http://jama.jamanetwork.com/article.aspx?articleid=1902220
Behind a paywall, but you can see the first page.
To the Editor
Management of brain arteriovenous malformations (bAVMs) has been
debated in the recent medical literature. If left untreated, bAVMs
confer a risk of neurological morbidity and mortality; however,
treatment is associated with risks but offers the potential for lifetime
eradication.
Dr Al-Shahi Salman and colleagues1
prospectively followed up 204 patients with unruptured bAVMs over 12
years. Morbidity and mortality rates among patients managed
conservatively vs those who underwent interventions (surgical resection,
endovascular treatment, radiosurgery, or multimodal intervention) were
compared. Over a 4-year period, the authors reported 36 events leading
to sustained disability or death in the conservative management group vs
39 in the intervention group. The number of bAVM-associated symptomatic
strokes or deaths in patients managed conservatively vs with an
intervention was 14 vs 38, respectively.
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