SURGICAL-MANAGEMENT OF SUPRATENTORIAL ARTERIOVENOUS-MALFORMATIONS

We present an overview of the surgical management of intracerebral arteriovenous malformations (AVM), including grading, patient evaluation, and preoperative as well as postoperative screening procedures with CT, MRI, and MR-angiography. In addition, surgical techniques are described in detail, with special consideration given to large AVM, paraventricular AVM, and functional area AVM. In terms of surgical results, we present data on relative outcomes, morbidity, and mortality as reported in major historical series. Although direct surgical excision is recommended for most cases, consideration should be given to embolization and radiosurgery; and we emphasize that the surgical decision-making process employ current grading systems to determine the relative risk-benefits of various treatment modalities.