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Updated: Apr 25, 2026
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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Stereotactic Radiosurgery for Brain Arteriovenous Malformations: A Radiosurgery Society Case-Based Guide
Rojine T Ariani1, Eulanca Y Liu1, Victor Goulenko2
1Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California.
Practical Radiation Oncology
|April 23, 2026
Summary
Stereotactic radiosurgery (SRS) offers effective, non-invasive treatment for brain arteriovenous malformations (AVMs). This guideline details SRS strategies for various AVM types, ensuring optimal patient outcomes and neurological preservation.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Vascular Neurology
Background:
- Brain arteriovenous malformations (AVMs) are complex vascular lesions with significant risks of hemorrhage and neurological deficits.
- Stereotactic radiosurgery (SRS) provides a non-invasive therapeutic option for AVM management, aiming for obliteration and functional preservation.
Purpose of the Study:
- To present a case-based guideline for contemporary management of brain AVMs using stereotactic radiosurgery (SRS).
- To summarize outcomes associated with SRS in treating diverse AVM presentations.
Main Methods:
- Illustrative cases included a small, unruptured Spetzler-Martin Grade I AVM treated with single-fraction SRS.
- A large Spetzler-Martin Grade V AVM managed with volume-staged SRS was presented.
- A ruptured Spetzler-Martin Grade II AVM treated with embolization followed by SRS was detailed.
Main Results:
- Single-fraction SRS demonstrates durable obliteration for smaller AVMs.
- Staged SRS approaches enable safe treatment of large or complex AVMs, complementing other modalities.
- Advanced imaging, precise delineation, and dose optimization are crucial for effective SRS planning.
Conclusions:
- Individualized patient selection and multidisciplinary collaboration are key for successful SRS in AVM management.
- Meticulous treatment planning and long-term surveillance are essential for optimizing safety and efficacy.
- SRS represents a valuable tool in the multidisciplinary approach to brain AVM treatment.
