Introduction

Abstract

Arteriovenous malformations (AVMs) of the brain are one of the most difficult diseases to manage. The benign defect of the cerebral circulation threatens the patient with epileptic seizures, neurological deficit, and most importantly bleeding that may be even be fatal. Today, the therapy of this complex disease is multidisciplinary, and specialties participating in therapy include microneurosurgery, interventional neuroradiology and stereotactic radiosurgery. All three specialties have their advantages and complications, each of them individually as well as in combination may bring a complete cure to many patients, and can also fail altogether. Even today, a percentage of arteriovenous malformations defy any therapy, the combined forces of all three specialties may not be enough to find a solution in some cases. Thus, observation alone became a legitimate policy and recently this is chosen for the majority of Spetzler–Martin Grade IV and V where the risks of treatment outweigh the natural course of the disease.