Outcomes of Microsurgical Resection of Low-Grade Cerebral Arteriovenous Malformations: A Descriptive Observational Multicenter Study from a Low-Middle-Income Country


  • Adnan Khaliq
  • Muhammad Hassan Raza Punjab Institute Of Neurosciences Lahore
  • Ahtesham Khizar
  • Muhammad Idris Khan
  • Nayab Gul
  • Adeeb-ul-Hassan Punjab Institute of Neurosciences, Lahore




Bridwell grading,


Objective:  To appraise the overall outcomes of microsurgical resection of low-grade arteriovenous malformations (AVMs) in a low-middle-income country.

Materials and Methods:  Data was collected from three different neurosurgical centers in Pakistan for this study and it lasted for two years. Patients who had been diagnosed with cerebral AVMs were categorized into three groups, A, B, and C, using the Spetzler-Martin (S-M) grading system. AVMs of grades 1 and 2 were included in Class A. Class B contained grade 3 AVMs, while Class C contained grade 4 and 5 AVMs. All male and female patients in Class A were eligible for this study. 

Results:  There were a total of 22 patients. The mean age was 36.41 ± 14.32 SD years. There were 12 (54.5%) male patients and 10 (45.5%) female patients. 13 patients (59.1%) presented with spontaneous intracerebral hemorrhage, while 9 patients (40.9%) presented with seizures. 14 patients (63.6%) had S-M grade 1 and 8 patients (36.4%) had S-M grade 2. All patients underwent microsurgical resection. We discovered 4.5% morbidity in our study. There was no postoperative mortality. According to the Glasgow outcome scale, an excellent functional outcome of 95.5% at 6 months and a 100% cure rate were noted.

Conclusion: Regarding morbidity, mortality, and cure rates for low-grade AVMs in our nation, microsurgery is a secure and efficient therapeutic option.


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