Objective: To evaluate the microsurgical treatment for sylvian fissure arteriovenous malformations (AVMs).
Methods: The clinical data of 94 sylvian fissure AVMs treated microsurgically was retrospectively collected. They were classified as medial, lateral, deep, anterior and simple AVMs according to the anatomic location of nidus in sylvian fissure.
Results: Total lesion removal was achieved in all patients and it was confirmed by postoperative digital subtraction angiography. Transient neurological deficits, including slight hemiparesis (n = 5, 5.3%) and aphasia (n = 4, 4.3%), were documented. Another 2 patients (2.1%) presented with a postoperative epidural and an intracranial hematoma respectively. However, an excellent outcome was observed in all patients as indicated by the Karnofsky performance scale > 90.
Conclusion: The microsurgical treatment for sylvian fissure AVMs has been greatly restrained by the involvement of multiple brain functional regions and its anatomic complexity. A more aggressive approach is recommended.