title: Treatment of arteriovenous malformations of the brain.
abstract: The treatment of ruptured and unruptured brain arteriovenous malformations (AVMs) is driven by the need to prevent incident or recurrent intracranial hemorrhages. Improving feasibility of the rapidly developing endovascular, neurosurgical, and radiotherapeutic procedures leads to invasive treatment of an increasing number of neurologically intact patients with accidentally diagnosed AVMs. Recent data confirm that the natural history risk of unruptured AVMs is significantly lower than the risk of those presenting with rupture, and the treatment risk of invasive management of unruptured AVMs seems higher than their natural history risk. The treatment decision algorithm for these patients remains unsettled, as no randomized clinical trial data exist on the benefit of invasive AVM treatment for patients with bled or with unbled AVMs. The recently launched study A Randomized Trial of Unruptured Brain AVMs (ARUBA) will be the first trial randomizing patients with nonhemorrhaged AVMs to invasive versus conservative management.
authors.affiliation: Stroke Unit, Department of Neurology, Charité Hochschulmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany. ahart@zedat.fu-berlin.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Hartmann
authors.forename: Henning
authors.initials: H
authors.lastname: Mast
authors.forename: Jae H
authors.initials: JH
authors.lastname: Choi
authors.forename: Christian
authors.initials: C
authors.lastname: Stapf
authors.forename: Jay P
authors.initials: JP
authors.lastname: Mohr
mesh_terms: D017542:Aneurysm, Ruptured / Q000209:etiology / Q000628:therapy; D001165:Arteriovenous Malformations / Q000628:therapy*; D001927:Brain Diseases / Q000628:therapy*; D002533:Cerebral Angiography / Q000379:methods; D002543:Cerebral Hemorrhage / Q000150:complications / Q000209:etiology; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D002538:Intracranial Arteriovenous Malformations; D019635:Neurosurgical Procedures; D012306:Risk