Cerebral Arteriovenous Malformations

Brain Cerebral arteriovenous malformations are focal intraparenchymal conglomerations of dilated arteries and veins which lack normal vascular organization at the subarteriolar level as well as a normal capillary bed resulting in direct connections between the cerebral arterial and venous systems present unique neurosurgical challenges. Classified based on size presence of deep draining veins and involvement of eloquent cortex.Most patients present for neurosurgical evaluation after an acute hemorrhage or after an AVM was found on imaging during the work up of other complaints such as seizures focal neurologic deficit or headaches. Increasingly cerebral arteriovenous malformations are found incidentally on imaging obtained for other reasons.The treatment of cerebral arteriovenous malformations is challenging and many therapeutic approaches have been proposed such as neurosurgery endovascular embolization radiosurgery and frequently the association of two or even three of these techniques.