Clinical Presentation, Grading, and Treatment Outcomes of Temporal Arteriovenous Malformations: A Systematic Review and Meta-Analysis

Temporal arteriovenous malformations (AVMs) represent a specific subset of intracranial AVMs often linked to eloquent cortical regions and seizure risk. Their clinical features and treatment results are not fully understood, especially regarding location-specific factors. This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, involving a comprehensive search of PubMed and Scopus for studies on temporal AVMs with available clinical and outcome data. Only studies focusing on lesions within the temporal lobe were included. Data collected encompassed patient demographics, clinical presentation, Spetzler-Martin grades, treatment methods, and outcomes, with pooled estimates computed via a random-effects model. Seventeen studies with 319 patients were analyzed. The average age was 38.0 years, with sex distribution being relatively balanced, with males representing 147/319 patients (46.1%) and a pooled male proportion of 51.5%. The most common presentations were hemorrhage (147/319, 46.1%) and seizures (115/319, 36.1%). Low-grade lesions (Spetzler-Martin I-II) were most frequent, followed by intermediate and high-grade types. Surgical resection was the primary treatment approach. Favorable functional outcomes (modified Rankin Scale ≤ 2 or good Glasgow Outcome Scale) occurred in 235 patients (73.7%), while 65 (20.4%) had poor outcomes. Mortality was low, at 10 patients (3.1%). Visual deficits were reported in 28 patients (8.8%), and permanent neurological deficits in 12 (3.8%). Recurrence was rare, observed in five patients (1.6%), with 10 patients (3.1%) needing reoperation. Temporal AVMs have a distinctive clinical profile, mainly involving seizures and hemorrhage, with microsurgical resection being the main treatment modality that yields high rates of favorable outcomes with acceptable morbidity. Adjunctive therapies like endovascular embolization and radiosurgery are used selectively based on specific clinical situations. Outcomes are affected by lesion features and treatment strategies, highlighting the importance of personalized management and the need for further high-quality research.