Treatment of cerebral arterio-venous malformations with laser.

The surgical application of the laser in the treatment of vascular diseases of the brain is based on its characteristic to perform an immediate or delayed modification of the vessel wall either by shrinking the collagenous fibres or by intraluminal thrombosis. Personal researches have been carried out to study the histological modifications of the vessel wall in normal arteries following laser irradiation with Nd:YAG. On this basis we have treated arterio-venous malformations (AVMs) in man. The laser enables radical surgery with a complete preservation of the healthy tissue surrounding the lesion because of reduced manipulation and the absence of intraoperative haemorrhage. Doppler technique and real-time ultrasonography are mostly suitable in the identification of the small deep-seated AVMs localizing the site of the malformation and the reactive glial tissue surrounding the lesion. The main indications are small AVMs located in critical areas of the brain.