Stereotactic radiosurgery for angiographically visible, intracranial, parenchymal arteriovenous malformations: A review

The goal of treatment of arteriovenous malformations (AVMs) is to eliminate the risk of hemorrhage, by complete removal or obliteration of the lesion, or both, with preservation of the patient's pretreatment neurologic status. To achieve this goal, one must weigh the risks and benefits of each available treatment option in light of knowledge of the natural history of untreated AVMs. Therapeutic options include microsurgery, radiosurgery, and embolization used either as single modality or multimodality treatment. Radiosurgery has been used both as the sole primary treatment and as an adjunctive treatment for small- to medium-sized, compact, angiographically visible, parenchymal AVMs, with obliteration rates of approximately 80% to 85% after a latency period of 2 to 3 years. The author reviews reported results of AVMs radiosurgery treatments, and elucidates an outline for the treatment strategies for parenchymal AVMs.