Multimodality treatment of cerebral arteriovenous malformations

Abstract

AbstractBackground: cerebral arteriovenous malformations (AVMs) , vascular lesions in the brain , can cause neurological complications like intracerebral hemorrhage. Treatment options include surgical excision , endovascular embolization , radiosurgery and multimodal therapy. Multimodality treatment uses two or more options to treat the same case , so maximizing the benefits of each option.Objectives: The aim is to evaluate outcome of patients with cerebral AVMs by surgery , embolization , radiosurgery and multimodality treatment in neurosurgery Department, Zagazig University Hospitals from May 2017 to May 2019.Patients and methods: 42 patients with AVM included 5 cases operated for excision, 23 cases for endovascular embolization, 14 cases for both endovascular embolization and gamma knife radiosurgery. in this study we used single modality approach (surgery or embolization) in 28 cases and multimodality approach (embolization followed by radiosurgery) in 14 cases.Results: multimodality treatment provides a better solution for large AVMs and those with residual nidus following embolization.Conclusion: management of AVMs depends on presenting symptoms , SMG , patient choice , center experience Key wordscerebral arteriovenous malformations, multimodality treatment, ruptured AVM , cerebral hemorrhage, unruptured AVM, stereotactic radiosurgery.