title: Diagnosis and evaluation of intracranial arteriovenous malformations.
abstract: BACKGROUND
  Ideal management of intracranial arteriovenous malformations (AVMs) remains poorly defined. Decisions regarding management of AVMs are based on the expected natural history of the lesion and risk prediction for peritreatment morbidity. Microsurgical resection, stereotactic radiosurgery, and endovascular embolization alone or in combination are all viable treatment options, each with different risks. The authors attempt to clarify the existing literature's understanding of the natural history of intracranial AVMs, and risk-assessment grading scales for each of the three treatment modalities.
  
  
  METHODS
  The authors conducted a literature review of the existing AVM natural history studies and studies that clarify the utility of existing grading scales available for the assessment of peritreatment risk for all three treatment modalities.
  
  
  RESULTS
  The authors systematically outline the diagnosis and evaluation of patients with intracranial AVMs and clarify estimation of the expected natural history and predicted risk of treatment for intracranial AVMs.
  
  
  CONCLUSIONS
  AVMs are a heterogenous pathology with three different options for treatment. Accurate assessment of risk of observation and risk of treatment is essential for achieving the best outcome for each patient.
authors.affiliation: Department of Neurosurgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Conger
authors.affiliation: Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Kulwin
authors.affiliation: Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Lawton
authors.affiliation: Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Aaron A
authors.initials: AA
authors.lastname: Cohen-Gadol
keywords: Complications; intracranial arteriovenous malformation; microsurgical resection; technique