Treatment Strategies and Key Points

Intracranial arteriovenous malformations (AVM) are among the lesions that are difficult to treat in neurosurgical practice. The main goal is to eliminate the risk of serious bleeding and progressive neurological deterioration. The location, size and venous drainage of the AVM are graded with the Spetzler-Martin Scale.

Treatment Options:

• Surgical
• Embolization (in case of pre-surgical necessity)
• Radiosurgery

The gold standard is total removal of the AVM using microsurgical method. After surgical removal, normal cerebral blood flow should be ensured. Partial resection may not eliminate the risk of bleeding.

Important points:

• Bleeding and high Spetzler-Martin stage increase mortality-morbidity.
• AVM treatment should be planned under the leadership of the neurosurgeon, and support should be received from other branches when necessary.
• Surgical treatment should be considered as the first choice in low-grade AVMs.
• Microsurgical resection can reduce mortality-morbidity by reducing the risk of bleeding in the postoperative period.

These strategic approaches allow AVM patients to receive effective and safe treatment.