BACKGROUND Posterior fossa arteriovenous malformations (pfAVMs) can be challenging lesions to manage. AVMs in this location may have distinct features compared with supratentorial AVMs. Our aim was to systematically review the literature on the presenting characteristics of pfAVMs and compare clinical and angiographic outcomes after the various types of treatment employed. METHODS The review was conducted according to the Cochrane Collaboration guidelines. Electronic databases from 1900 to March 2018 were searched and complemented by hand-searching and cross-referencing. Articles were categorized into (i) AVM studies that included those in the posterior fossa, (ii) those that focused exclusively on pfAVM, and (iii) those that further specified a cerebellar or brainstem location of the AVM. RESULTS Seventy-seven articles with 4512 pfAVM patients were retained for analyses. Compared with historical supratentorial controls, pfAVMs were reported to more frequently present with rupture, to more commonly have associated arterial aneurysms, and to more frequently lead to poor clinical and angiographic outcomes. The quality of the literature and lack of standardization of outcome reporting precluded performing a meta-analysis on the results of the various different treatment modalities. CONCLUSIONS Posterior fossa AVMs may have some distinct features compared with supratentorial AVMs. The available reports on pfAVMs are not sufficiently standardized to provide reliable guidance for patient management decisions. This goal will require future studies to be multicentric and to focus on standardized, repeatable clinical and angiographic outcomes.

中文翻译：

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后颅窝动静脉畸形：系统评价。

背景后颅窝动静脉畸形 (pfAVM) 可能是难以管理的病变。与幕上 AVM 相比，该位置的 AVM 可能具有不同的特征。我们的目的是系统地回顾有关 pfAVM 呈现特征的文献，并比较采用不同类型治疗后的临床和血管造影结果。方法 该评价是根据 Cochrane 协作指南进行的。通过手工搜索和交叉引用对1900年至2018年3月的电子数据库进行了搜索和补充。文章被分类为 (i) 包括后颅窝的 AVM 研究，(ii) 专门关注 pfAVM 的研究，以及 (iii) 进一步指定 AVM 的小脑或脑干位置的研究。结果 包含 4512 名 pfAVM 患者的 77 篇文章被保留用于分析。与历史幕上对照相比，据报道 pfAVM 更常出现破裂，更常伴有动脉瘤，并且更常导致较差的临床和血管造影结果。文献的质量和结果报告缺乏标准化阻碍了对各种不同治疗方式的结果进行荟萃分析。结论 与幕上 AVM 相比，后颅窝 AVM 可能具有一些不同的特征。现有的 pfAVM 报告不够标准化，无法为患者管理决策提供可靠的指导。这个目标将要求未来的研究是多中心的，并专注于标准化、