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The treatment of brain arteriovenous malformations supplied by deep perforating arteries (PA) (P-BAVM) remains challenging. The aims of this study were to determine the outcomes after surgical treatment in patients with P-BAVMs and to identify the risk factors associated with postoperative neurological deficits. We retrospectively reviewed the medical charts and imaging records of 228 consecutive patients with BAVMs who underwent microsurgical resection of their BAVMs at Beijing Tiantan Hospital between September 2012 and March 2016. Patients were included if the BAVMs were totally or partially supplied by PA. All patients had undergone preoperative diffusion tensor imaging (DTI), MRI, 3D time-of-flight MRA (3D TOF-MRA) and digital subtraction angiography (DSA) followed by resection. Both functional and angioarchitectural factors were analysed with respect to the postoperative neurological deficits, including motor deficits, visual field deficits and aphasia. Statistical analysis was performed using the statistical package SPSS (version 20.0.0, IBM Corp.). Fifty-nine patients with P-BAVMs were enrolled. Radical obliteration was achieved in all P-BAVMs according to postoperative DSA. Forty-five (76.3%) patients obtained neurological deficits 1 week after surgery. At a mean follow-up of 14.7 ± 9.4 (3-30) months after surgery, 34 patients (57.6%) had long-term neurological deficits. Multivariable logistic regression analyses showed that a shorter lesion-to-eloquent fibre tracts distance (LFD) was an independent risk factor for short- ( P = 0.014) and long-term ( P = 0.013) neurological deficits. The cut-off point of LFD for long-term neurological deficits was 5.20 mm. The predominant supply of the PA ( P = 0.008) was an independent risk factor for long-term neurological deficits. This study identified a high risk of surgical morbidity for P-BAVMs. The predominant supply of the PA and a shorter LFD are crucial risk factors for postoperative neurological deficits in patients with P-BAVMs. [ABSTRACT FROM AUTHOR]

The primary aim of this study is to assess the value of intraoperative near-infrared indocyanine green videoangiography (ICGA) during intracranial aneurysm surgery. Altogether, 129 patients harboring 152 intracranial aneurysms were recruited in this study between March 2007 and December 2008 and the clinical data were retrospectively analyzed. Intraoperative ICGA was performed to examine the completeness of the aneurysm clipping and the patency of the parent arteries in all cases. The intraoperative findings were compared with that of postoperative digital subtraction angiography (DSA). On all of the patients, 276 successful ICGA investigations were performed intraoperatively. The image quality and resolution were excellent, allowing real-time assessment of the cerebral circulation. Indocyanine green (ICG) angiographic results could be divided into arterial, capillary, and venous phases, comparable to those observed with postoperative DSA. In all cases, the postoperative angiographic results corresponded to the intraoperative ICGA findings. In three cases, the information provided by intraoperative ICG angiography significantly changed the surgical procedure. Intraoperative ICG videoangiography may be a useful tool in real-time evaluation of the aneurysm clipping. Its simplicity and easy reproducibility all suggest it to be carried out as a routine procedure during aneurysm surgery.