The main aim of this study is to define the clinical criteria which
must be considered in order to come to an adequate decision whether
a patient with intracranial arteriovenous malformation (AVM) should
be operated upon or treated conservatively. A special method was
used to reduce the effects of selection. This method made it
possible to evaluate the therapeutic efficacy of conservative
treatment versus surgery. The method implies that patients with
equal combinations of variables (risk profiles) were compared in
the two treatment lines. The variables building up the risk-profile
pattern were chosen by analysing the decision process, as it was
originally practiced by the surgeon who selected and treated the
patients of this study. The risk profiles thus described relevant
characteristics of the patient and his malformation. The variables
were assigned numerical values accord ing to their prognostic
value. Summation of the variables making up the risk profile then
gives each risk profile a certain value. A low value symbolizes a
bad prognosis and a high value a good prognosis in both treatment
groups. There were many risk profiles with the same value in both
groups and a comparison could be made over a large part of the
risk-profile scale. This comparison showed that surgical treatment
of A VM can always be justified, although the indications for
surgery are less strong in patients with low risk profile values."
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