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Mental health and quality of life in patients with ruptured and unruptured cerebral arteriovenous malformation
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DOI：10.1055/s-0046-1820530.png)
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Abstract
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Background Cerebral arteriovenous malformation (cAVM) is a rare and complex cerebrovascular disease that may cause neurological symptoms, cognitive complaints, and psychological distress even without hemorrhage, potentially impairing long-term quality of life. Objective To assess the impact of cAVM on mental health and quality of life, considering patients' clinical presentation and the type of treatment received. Methods In the present cross-sectional study, adults aged 18 to 65 with ruptured or unruptured cAVM treated with conservative, or multimodal approaches were recruited. Data were collected through an online survey distributed by participating institutions. Mental health, psychological distress, and quality of life were evaluated using the 5-item Mental Health Index (MHI-5), the Self-Reporting Questionnaire (SRQ-20), and the World Health Organization Quality of Life-brief version questionnaire (WHOQOL-BREF). Results were categorized and compared with normative data. Statistical analyses included descriptive statistics, analysis of variance (ANOVA), t-tests, chi 2 , and Fisher's exact tests. Results Eighty-six participants with cAVM completed the questionnaire. Unruptured lesions accounted for 62.8% and ruptured cAVM 37.2%. Neurological deficits were reported by 94.2% of participants. Among conservatively-managed unruptured cases, 47.1% reported neurological deficits, without significant differences when compared with other treatments. Despite similar neurological status, conservatively managed unruptured patients showed poorer mental health ( p = 0.048) and lower quality of life in the physical ( p < 0.001) and social domains ( p = 0.016). Conclusion Patients with unruptured cAVM managed conservatively exhibit significantly worse mental health and reduced physical and social quality of life, despite a similar prevalence of neurological deficits relative to other groups. These findings highlight the importance of incorporating psychosocial outcomes into treatment decision-making for cAVM.
Keywords:
Intracranial Arteriovenous Malformations
Quality of Life
Mental Health
Cerebrovascular Disorders
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