Surgery for Brain Arteriovenous Malformations

Cerebral arteriovenous malformations (AVMs) are very specific entities of vascular anomalies, characterised by anatomical shunting where arterial blood flows directly into the venous circulation through the nidus of the pathological vessels. Surgery of brain AVMs is based on a detailed understanding not only of the brain itself but also of the AVM’s localisation and the length of the feeding arteries, the architecture of the nidus, and the course of the venous drainage. Every surgery should be well planned based on a detailed study of imaging scans, namely angiography with 3D reconstructions and MR to determine the precise location and volume of the nidus. The treatment must be preceded by decision-making process to choose the best treatment option for each patient. This chapter deals with the anatomy of brain AVMs and their application in the surgical management of these malformations. The chapter highlights the important surgical steps in dealing with an AVM.