• 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 Nov 1; 191: e107e115e107-e115.

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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