Diagnosis and Treatment of Vascular Malformations of the Brain

Part of the following topical collections:
  1. Topical Collection on Cerebrovascular Disorders

Opinion statement

Vascular malformations of the brain are often found in the workup of intracranial hemorrhage, seizures, focal neurological deficits, or headaches. Although CT-angiography may reveal an underlying arteriovenous malformation (AVM) or arteriovenous fistula (AVF), other vascular malformations are not easily evaluated on CT and are better seen on magnetic resonance imaging. For the evaluation of AVMs and AVFs, formal digital subtraction angiography remains the gold standard. In the case of AVMs, AVFs, or cavernous malformations (CMs), the lesion may serve as the etiologic source of the symptoms and thus warrant treatment. When feasible, microsurgical resection is the optimal treatment option for AVMs and CMs. Endovascular embolization may serve as a crucial adjunct to microsurgery in the treatment of AVMs. Depending on their vascular anatomy, AVFs may be treated by either endovascular embolization or microsurgery. For inoperable AVMs and dural AVFs necessitating treatment, stereotactic radiosurgery (SRS) may serve as a viable treatment alternative. Capillary telangiectasias and developmental venous anomalies (DVAs) are often incidental findings; they may be found in association with CMs but are not generally considered targets for treatment. Herein, we review diagnostic methods, natural history, and treatment options for these cerebral vascular malformations.


AVM Arteriovenous malformation AVF Arteriovenous fistula dAVF Dural arteriovenous fistula Diagnosis Treatment Cavernous malformation Cavernoma Capillary telangiectasia DVA Developmental venous anomaly Venous angioma Angiography Natural history Microsurgery Embolization Radiosurgery Stereotactic radiosurgery SRS 


Compliance with Ethics Guidelines

Conflict of Interest

Bradley A. Gross and Rose Du declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Neurological SurgeryBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA

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