{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:24:52Z","timestamp":1791314692096,"version":"4.3.1"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,10]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>In this study, the authors evaluated how an appropriate allocation of patients with occipital arteriovenous malformations (AVMs) who were treated according to different strategies would affect nonhemorrhagic headache, visual function, and hemorrhage risk levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Of the 712 patients with brain AVMs in the Toronto Western Hospital prospective database, 135 had occipital AVMs. The treatment decision was based on patients' characteristics, presentation, and morphology of the AVM. The management modalities were correlated with their outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean follow-up period was 6.78 years. Nonhemorrhagic headache was the most frequent symptom (82 [61%] of 135 patients). Ninety-four patients underwent treatment with one or a combination of embolization, surgery, or radiosurgery, and 41 were simply observed. Of the 40 nontreated patients with nonhemorrhagic headache, only 12 (30%) showed improvement. In the observation group 2 patients (22%) had worsening of visual symptoms, and 2 experienced hemorrhage, for an annual hemorrhage rate of 0.7% per year; 1 patient died. In the treatment group, the improvement in nonhemorrhagic headache in 35 patients (83%) was significant (p &lt; 0.0001). Visual deficit at presentation worsened in 2 (8%), and there were 8 new visual field deficits (9%). The visual worsening was not significantly different. There were 2 other neurological deficits (2%) and 2 deaths (2%) related to the AVM treatment. One AVM hemorrhaged. The annual hemorrhage rate was 0.1% per year. The hemorrhage risk in the observation and treatment groups was lower than the observed hemorrhage risk of all patients with AVMs (4.6%) at the authors' institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Appropriate selection of patients with occipital AVMs for one or a combination of treatment modalities yields a significant decrease in nonhemorrhagic headache without significant visual worsening. The multidisciplinary care of occipital AVMs can aim for an apparent decrease in hemorrhage risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2009.11.jns09884","type":"journal-article","created":{"date-parts":[[2010,1,8]],"date-time":"2010-01-08T13:42:09Z","timestamp":1262958129000},"page":"742-748","source":"Crossref","is-referenced-by-count":35,"title":["Multidisciplinary care of occipital arteriovenous malformations: effect on nonhemorrhagic headache, vision, and outcome in a series of 135 patients"],"prefix":"10.3171","volume":"113","author":[{"given":"Amir R.","family":"Dehdashti","sequence":"first","affiliation":[{"name":"Divisions of Neurosurgery and"},{"name":"Department of Neurosurgery, Geisinger Neurosciences Institute, Danville, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Thines","sequence":"additional","affiliation":[{"name":"Divisions of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Willinsky","sequence":"additional","affiliation":[{"name":"Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University of Toronto, Ontario, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karel G.","family":"terBrugge","sequence":"additional","affiliation":[{"name":"Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University of Toronto, Ontario, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Divisions of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Tymianski","sequence":"additional","affiliation":[{"name":"Divisions of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Christopher","family":"Wallace","sequence":"additional","affiliation":[{"name":"Divisions of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns09884","series-title":"Neurosurgery","first-page":"443","article-title":"Embolization before radiosurgery reduces the obliteration rate of arteriovenous malformations","volume":"60","author":"Andrade-Souza","year":"2007"},{"key":"b2-jns09884","series-title":"Neurosurgery","first-page":"1046","article-title":"Surgical management of arteriovenous malformations in the region of the ventricular trigone","volume":"35","author":"Barrow","year":"1994"},{"key":"b3-jns09884","series-title":"Neurosurgery","first-page":"415","article-title":"Occipital lobe vascular malformations: prevalence of visual field deficits and prognosis after therapeutic intervention","volume":"43","author":"Bartolomei","year":"1998"},{"key":"b4-jns09884","series-title":"J Neurosurg","first-page":"511","article-title":"Surgical approaches to trigonal arteriovenous malformations","volume":"67","author":"Batjer","year":"1987"},{"key":"b5-jns09884","series-title":"Cephalalgia","first-page":"191","article-title":"Intracranial arteriovenous malformation and migraine","volume":"4","author":"Bruyn","year":"1984"},{"key":"b6-jns09884","series-title":"Stroke","first-page":"100","article-title":"The natural history and predictive features of hemorrhage from brain arteriovenous malformations","volume":"40","author":"da Costa","year":"2009"},{"key":"b7-jns09884","series-title":"Headache","first-page":"509","article-title":"Arteriovenous malformations and migraine: case reports and an analysis of the relationship","volume":"31","author":"Haas","year":"1991"},{"key":"b8-jns09884","series-title":"J Neurosurg","first-page":"3","article-title":"Intention-to-treat analysis of Spetzler-Martin Grades IV and V arteriovenous malformations: natural history and treatment paradigm","volume":"98","author":"Han","year":"2003"},{"key":"b9-jns09884","series-title":"Neurosurgery","first-page":"823","article-title":"Natural history of brain arteriovenous malformations: a long-term follow-up study of risk of hemorrhage in 238 patients","volume":"63","author":"Hernesniemi","year":"2008"},{"key":"b10-jns09884","series-title":"Neurology","first-page":"953","article-title":"Occipital arteriovenous malformations: visual disturbances and presentation","volume":"46","author":"Kupersmith","year":"1996"},{"key":"b11-jns09884","series-title":"J Neurosurg","first-page":"224","article-title":"Headaches in patients with radiosurgically treated occipital arteriovenous malformations","volume":"93","author":"Kurita","year":"2000"},{"key":"b12-jns09884","series-title":"J Neurosurg","first-page":"798","article-title":"Medial occipital arteriovenous malformations. 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Functional magnetic resonance imaging studies before and after therapeutic intervention","volume":"28","author":"Schlosser","year":"1997"},{"key":"b23-jns09884","series-title":"Stroke","first-page":"2395","article-title":"Quality of life of stroke in younger individuals. Utility assessment in patients with arteriovenous malformations","volume":"28","author":"Shin","year":"1997"},{"key":"b24-jns09884","series-title":"J Neurosurg","first-page":"842","article-title":"Risk of hemorrhage from an arteriovenous malformation confirmed to have been obliterated on angiography after stereotactic radiosurgery","volume":"102","author":"Shin","year":"2005"},{"key":"b25-jns09884","series-title":"Neurosurgery","first-page":"655","article-title":"Visual field preservation after curative multi-modality treatment of occipital lobe arteriovenous malformations","volume":"57","author":"Sinclair","year":"2005"},{"key":"b26-jns09884","series-title":"J Neurosurg","first-page":"476","article-title":"A proposed grading system for arteriovenous malformations","volume":"65","author":"Spetzler","year":"1986"},{"key":"b27-jns09884","series-title":"Headache","first-page":"193","article-title":"Daily migraine with visual aura associated with an occipital arteriovenous malformation","volume":"41","author":"Spierings","year":"2001"},{"key":"b28-jns09884","series-title":"Neurology","first-page":"1350","article-title":"Predictors of hemorrhage in patients with untreated brain arteriovenous malformation","volume":"66","author":"Stapf","year":"2006"},{"key":"b29-jns09884","series-title":"Stroke","first-page":"1220","article-title":"Large and deep brain arteriovenous malformations are associated with risk of future hemorrhage","volume":"33","author":"Stefani","year":"2002"},{"key":"b30-jns09884","series-title":"J Neurosurg","first-page":"1","article-title":"Clinical outcome of radiosurgery for cerebral arteriovenous malformations","volume":"77","author":"Steiner","year":"1992"},{"key":"b31-jns09884","series-title":"J Neurosurg","first-page":"810","article-title":"Complications of preoperative embolization of cerebral arteriovenous malformations","volume":"100","author":"Taylor","year":"2004"},{"key":"b32-jns09884","series-title":"Arch Ophthalmol","first-page":"250","article-title":"Occipital lobe arteriovenous malformations. Clinical and radiologic features in 26 cases with comments on differentiation from migraine","volume":"93","author":"Troost","year":"1975"},{"key":"b33-jns09884","series-title":"J Neurosurg","first-page":"965","article-title":"Risk factors for subsequent hemorrhage in patients with cerebral arteriovenous malformations","volume":"107","author":"Yamada","year":"2007"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/113\/4\/article-p742.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/113\/4\/article-p742.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/113\/4\/article-p742.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:37:30Z","timestamp":1679877450000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/113\/4\/article-p742.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2010,10]]},"references-count":33,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2009.11.jns09884","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,10]]}}}