Treatment of arteriovenous malformations of the brain.

Arteriovenous malformations (AVMs) of the brain are complex, congenital, high-flow vascular lesions in which there is a direct fistulous connection between arteries and veins without an intervening capillary bed. Patients commonly present with hemorrhage or seizures. Treatment must take into account the natural history of these lesions and the risks related to their treatment. To date, there have been no prospective, randomized, controlled clinical trials to determine the optimal method of treatment of brain AVMs. However, multiple retrospective analyses of treatment strategies and surgical results in patients with brain AVMs reveal that the management of brain AVMs requires a multimodal, multidisciplinary treatment approach, utilizing surgical resection, endovascular embolization, and/or stereotactic focused-beam radiosurgery.