Abstract
The successful treatment of brain vascular malformations has always been a formidable undertaking. The inadvertent discovery of an arteriovenous malformation (AVM) confronts both patient and physician with a dilemma difficult to resolve. The patient, who feels well, faces the possibility of a disastrous brain hemorrhage in the future but knows that the treatment to obviate this potential disaster is not without risk. What is the likelihood of hemorrhage? How great is the risk of surgical extirpation? When there are symptoms such as headache, epileptic seizures or progressive neurological deficit the surgeon must consider the risk of surgical intervention with the knowledge that complete, uncomplicated excision of the AVM may still fail to alleviate the symptom for which the operation was done. When a brain vascular malformation presents with hemorrhage, the decision for surgery may very well be easier but its successful accomplishment very difficult. We are learning to stratify the surgical risk according to the features of vascular malformations and balance this against the probability of future hemorrhage56,98.
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Gentili, F., Schwartz, M., TerBrugge, K., Wallace, M.C., Willinsky, R., Young, C. (1992). A Multidisciplinary Approach to the Treatment of Brain Vascular Malformations. In: Symon, L., et al. Advances and Technical Standards in Neurosurgery. Advances and Technical Standards in Neurosurgery, vol 19. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6672-7_6
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