Related Experiment Video
Updated: Apr 16, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Management of posterior fossa arteriovenous malformations
Joao Paulo Almeida1, Roberto Medina1, Rafael J Tamargo1
1Department of Neurosurgery, Division of Cerebrovascular Neurosurgery, The Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA.
Background:
Posterior fossa arteriovenous malformations (AVMs) are rare vascular lesions, representing 7-15% of all intracranial AVMs. Although less frequent than supratentorial AVMs, they present higher rupture, morbidity, and mortality rates. Microsurgery, radiosurgery, and endovascular neurosurgery are treatment options for obliteration of those lesions. In this paper, we present a critical review of the literature about the management of posterior fossa AVM.
Methods:
A MEDLINE-based search of articles published between January 1960 and January 2014 was performed. The search terms: "Posterior fossa arteriovenous malformation," "microsurgery," "radiosurgery," and "endovascular" were used to identify the articles.
Results:
Current data supports the role of microsurgery as the gold standard treatment for cerebellar AVMs. Brainstem AVMs are usually managed with radiotherapy and endovascular therapy; microsurgery is considered in cases of pial brainstem AVMs.
Conclusions:
Succsseful treatment of posterior fossa AVMs depend on an integrated work of neurosurgeons, radiosurgeons, and endovascular neurosurgery. Although the development of radiosurgery and endovascular techniques is remarkable, microsurgery remains as the gold standard treatment for most of those lesions.
Insights
Posterior fossa arteriovenous malformations (AVMs) are rare but dangerous. Microsurgery is the preferred treatment for cerebellar AVMs, while brainstem AVMs often involve radiotherapy and endovascular therapy.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Surgery
Background:
- Posterior fossa arteriovenous malformations (AVMs) are uncommon intracranial vascular lesions, accounting for 7-15% of all AVMs.
- These AVMs exhibit higher rates of rupture, morbidity, and mortality compared to supratentorial AVMs.
- Management options include microsurgery, radiosurgery, and endovascular neurosurgery.
Purpose of the Study:
- To critically review the existing literature on the management of posterior fossa AVMs.
- To evaluate the efficacy and indications of different treatment modalities.
- To provide insights into the current treatment strategies for these complex lesions.
Main Methods:
- A comprehensive literature search was conducted using MEDLINE.
- Articles published between January 1960 and January 2014 were included.
- Search terms included "Posterior fossa arteriovenous malformation," "microsurgery," "radiosurgery," and "endovascular."
Main Results:
- Microsurgery is recognized as the gold standard for treating cerebellar AVMs.
- Brainstem AVMs are typically managed with radiotherapy and endovascular therapy.
- Microsurgery may be considered for specific cases of pial brainstem AVMs.
Conclusions:
- Successful management of posterior fossa AVMs requires a multidisciplinary approach involving neurosurgeons, radiosurgeons, and endovascular specialists.
- Despite advancements in radiosurgery and endovascular techniques, microsurgery remains the primary treatment for most posterior fossa AVMs.
- Integrated treatment strategies are crucial for optimizing outcomes in patients with these challenging vascular malformations.
Related Concept Videos
01:22Aneurysm IV: Nursing Management
01:25Hemodialysis I: Introduction
01:26Aneurysm III: Interprofessional Care