• Gutierrez PinedaFelipeFDepartment of Neurosurgery, Universidad de Antioquia, School of Medicine, Medellin, Colombia; Department of Neurosurgery, Instituto Neurologico de Colombia, Medellin, Colombia., Esteban Quiceno, Mauro Marcelo Suarez Marin, and Francisco Javier Londoño Ocampo.
• Department of Neurosurgery, Universidad de Antioquia, School of Medicine, Medellin, Colombia; Department of Neurosurgery, Instituto Neurologico de Colombia, Medellin, Colombia.
• World Neurosurg. 2024 Aug 20.

BackgroundSurgical timing after rupture of brain arteriovenous malformations (AVMs) is controversial. There is scarce literature on AVM surgical outcomes from developing countries. This study aims to determine if there is a difference between early and delayed surgical resection for patients with ruptured brain AVMs.MethodsThis single-center retrospective review included patients who underwent surgical resection for ruptured brain AVMs in Colombia. Patients were stratified by the timing of surgical intervention relative to the rupture into early (≤72 hours of bleeding) and delayed (>72 hours) resection. Continuous variables were analyzed using an independent t-test, and dichotomous variables were analyzed using a χ2 test. A linear regression analysis was performed with the final mRankin score at 2 years as the dependent variable; P < 0.05 was considered significant.ResultsThirty-one patients were identified. The early treatment group included 14 (45.2%) patients, and the delayed group included 17 (54.8%) patients. The mean (SD) length of time between AVM rupture and surgical resection was 1.6 ± 1.2 days and 12.4 ± 8.4 days, respectively (P < 0.001). There were no differences regarding demographics, perioperative variables, and postoperative outcomes between groups. In the linear regression analysis, the only variable that had a significant association with the final mRankin score was the initial Glasgow Coma Scale, which had a β coefficient of -0.6341 (95% confidence interval: -0.41,-0.017, P = 0.035).ConclusionsIn this case series of 31 patients from a developing country, there were no differences in clinical outcomes at the final follow-up between acute and delayed surgical interventions for ruptured AVMs. The most important factor associated with the final outcomes was the initial Glasgow Coma Scale.Copyright © 2024 Elsevier Inc. All rights reserved.

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