Arteriovenous Malformations: Surgical Indications and Technique

Arteriovenous malformations (AVMs) are characterized by direct arterial-to-venous shunting, usually through a tangle of vessels called a nidus, without the normal intervening capillary beds, and are thus considered to be high-pressure, high-flow malformations. Clinical sequelae include headaches, seizures, and progressive neurological deficits from vascular steal and rupture. Treatment options include observant with medical management of symptoms, radiosurgery, endovascular embolization, and surgical resection. Often a multimodal treatment is employed. In this chapter we focus on the indications and techniques for surgical resection of AVMs.