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Updated: Apr 25, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
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.
Purpose:
Brain arteriovenous malformations (AVMs) are high-risk vascular anomalies associated with hemorrhage, neurological morbidity, and mortality. Stereotactic radiosurgery (SRS) is a well-established, noninvasive treatment that achieves durable obliteration while preserving neurological function. This case-based guideline summarizes contemporary SRS-based AVM management and outcomes.
Methods And Materials:
Three illustrative cases were selected: a small, unruptured Spetzler-Martin grade (SMG) I AVM treated with single-fraction SRS, a large SMG V AVM managed with volume-staged SRS, and a ruptured SMG II AVM treated with embolization followed by definitive SRS.
Results:
Single-fraction SRS achieves durable obliteration for small AVMs, whereas staged approaches allow safe treatment of large or complex lesions and complement microsurgery and embolization. Treatment planning emphasizes integration of advanced imaging, precise nidus delineation, and dose-volume optimization. Long-term surveillance remains essential to confirm obliteration and detect delayed complications.
Conclusions:
This case-based guideline highlights practical principles of SRS for brain AVM management, emphasizing individualized selection, multidisciplinary collaboration, and meticulous planning to optimize safety and efficacy.
