Surgical indications for arteriovenous malformations in patients over the age of 60 years: retrospective analysis of 33 patients.

This retrospective study investigated the surgical indications in 33 patients aged > 60 years with brain arteriovenous malformation (AVM) taken from a group of 294 cases between 1981 and 2004. These 33 patients were further classified to two age groups: 60 - 64 years (A group) and > or = 65 years (B group). The overall haemorrhagic rate at initial presentation was 46.6% in the 294 patients. The rate was 48.5% in patients aged > 60 years, and 72.2 and 20% in the A and B groups, respectively. In three of four cases with extremely poor outcome with modified Rankin Scale 5 and 6, the cause of poor outcome was haemorrhage in those aged > 65 years. Because of the high haemorrhagic rate and poor outcome after haemorrhage, surgical treatment is indicated for patients aged > 60 years.