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Updated: Jul 3, 2026
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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Treatment selection for cerebral arteriovenous malformations: radiosurgery or microsurgery
K Ehara1, N Tamaki, M Nakamura
1Department of Neurosurgery, Kobe University School of Medicine, Kobe, Japan.
Summary
For cerebral arteriovenous malformations (AVMs), total surgical removal offers the best results, though radiosurgery shows lower morbidity. Treatment decisions require balancing mortality, morbidity, and cure rates for each patient.
Area of Science:
- Neurology
- Neurosurgery
- Radiation Oncology
Background:
- Cerebral arteriovenous malformations (AVMs) pose significant risks, including hemorrhage and neurological deficits.
- Treatment options for AVMs include surgery, radiosurgery, and conservative management, each with distinct outcomes.
Purpose of the Study:
- To analyze and compare the clinical outcomes, mortality, and morbidity of different treatment modalities for cerebral AVMs.
- To provide data to guide treatment decisions based on individual patient characteristics and risk-benefit analysis.
Main Methods:
- Retrospective analysis of 318 patients with cerebral AVMs.
- Comparison of outcomes between surgical treatment (total and subtotal removal) and radiosurgery (gamma-knife and linac-knife).
- Standardized clinical data analysis protocol applied to surgery and radiosurgery groups.
Main Results:
- Total surgical removal of AVMs yielded the best clinical results.
- Radiosurgery demonstrated the lowest morbidity rates.
- Operative mortality for total surgical removal was 1%; radiosurgery mortality was 0.7%.
- Total obliteration rates were higher with surgery compared to radiosurgery.
Conclusions:
- Total AVM resection provides superior clinical outcomes.
- Radiosurgery offers a lower morbidity profile.
- Treatment selection necessitates careful consideration of mortality, morbidity, and cure rates for each modality.
