KẾT QUẢ ĐIỀU TRỊ PHẪU THUẬT DỊ DẠNG ĐỘNG TĨNH MẠCH NÃO HỐ SAU VỠ TẠI BỆNH VIỆN BẠCH MAI

Abstract

Objective: To describe the clinical characteristics, radiological features, and evaluate the surgical treatment outcomes of ruptured posterior fossa arteriovenous malformations (AVMs) at Bach Mai Hospital. Methods: This retrospective descriptive study included 63 patients diagnosed with ruptured posterior fossa AVMs who underwent surgery in the Department of Neurosurgery at Bach Mai Hospital from January 2020 to June 2025. Results: The mean age was 35.97 ± 12.6 years, with 29 males and 34 females. Most patients were admitted with acute cerebellar hemorrhage, presenting with headache (79.3%), dizziness (42.9%), and altered consciousness (28.6%); seizures were rare (3.2%). Intraventricular hemorrhage occurred in 51% of cases, causing acute hydrocephalus in 22%. Regarding AVM characteristics, 90.5% were smaller than 3 cm in size; the main feeding artery was the posterior inferior cerebellar artery (68.3%). Deep venous drainage was present in 55.6% of cases, and 41.3% had associated aneurysms. Preoperative embolization was performed in 20 of 63 cases (31.7%). Microsurgical resection of the AVM was performed in 57 patients, achieving a complete resection rate of 93%. Postoperatively, 28 of 63 patients (44.4%) experienced at least one complication. At 3-month follow-up, 47 of 63 patients (74.6%) had a good recovery (modified Rankin Scale 0–2), 8 patients (12.7%) had moderate deficits, and 8 (12.7%) had severe deficits or died. Conclusion: Ruptured posterior fossa AVMs present an acute, life-threatening condition. Surgical treatment is effective. A multimodal treatment approach tailored to the clinical and radiological features of each case yields good outcomes.