Staged embolization with staged gamma knife radiosurgery to treat a large AVM.

摘要

Treatment of arteriovenous malformations (AVMs) is complicated because of many factors including increasing size, eloquent location, and risk of unacceptable neurological deficits. Each of the treatment modalities, microsurgery, embolization, and stereotactic radiosurgery (SRS), has its pros and cons. Surgery and embolization are limited by location, size, and afferent and efferent vessel anatomy. Stereotactic radiosurgery is limited by size and location, with increasing volume of the AVM resulting in decreasing the therapeutic dose. Many articles address the concern of high dose radiation not being able to be used in SRS over a large volume.