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(Circulation. 2001;103:2644.)
© 2001 American Heart Association, Inc.

AHA Scientific Statement

Recommendations for the Management of Intracranial Arteriovenous Malformations

A Statement for Healthcare Professionals From a Special Writing Group of the Stroke Council, American Stroke Association

Christopher S. Ogilvy, MD, Chair; Philip E. Stieg, PhD, MD; Issam Awad, MD; Robert D. Brown, Jr, MD; Douglas Kondziolka, MD; Robert Rosenwasser, MD; William L. Young, MD; George Hademenos, PhD

Key Words: AHA Scientific Statements • arteriovenous malformations • stroke • cerebrovascular disease • hemorrhage

	I. Introduction

 
Intracranial arteriovenous malformations (AVMs) are relatively uncommon but increasingly recognized lesions that can cause serious neurological symptoms or death. Although AVMs can present with hemorrhage or seizure, since the advent of contemporary brain imaging techniques, an increasing number are detected before rupture. Over the last decade, there have been significant developments in the management of intracranial AVMs. There has been an evolution of microsurgical as well as endovascular and radiosurgical techniques to treat these lesions. As the management options have evolved, individual and combined modality treatment protocols have been developed in different institutions for the management of AVMs.

A writing group was formed by the Stroke Council of the American Stroke Association to review published data for intracranial AVMs to develop practice recommendations regarding epidemiology, natural history, potential treatment strategies, and outcomes. The reports reviewed for this synthesis were selected on the basis of study design, sample size, and relevance to a particular topic. Each report was graded according to previously defined criteria.^{1 2} After review of the available literature, recommendations for current practice standards have been made according to 3 separate grades (Table 1).

View this table: [in this window] [in a new window]   Table 1. Levels of Evidence in Grading of Recommendations for Treatment of Patients With Subarachnoid Hemorrhage

By the design of this type of review, the recommendations in this report represent an overview of existing treatment protocols that may vary considerably. These guidelines were developed to serve as a basis for the development of treatment strategies for AVMs, which overall represent a fairly heterogeneous group of cerebrovascular lesions . . . [Full Text of this Article]

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