MICROSURGERY AND STEREOTACTIC RADIOSURGERY FOR TREATMENT OF PATIENTS WITH BRAIN ARTERIOVENOUS MALFORMATION

Resumo

Cerebral arteriovenous malformations (AVMs) pose a significant challenge in clinical management due to their complex nature and potential for severe complications. This review provides a comprehensive analysis of therapeutic options for AVMs, including microsurgery, stereotactic radiosurgery (SRS), and embolization, based on a thorough examination of existing literature. Eight studies involving 817 patients underscored microsurgery’s superiority in achieving complete obliteration of AVMs and reducing the risk of bleeding during follow-up, despite a higher incidence of post-operative neurological deficits. Notably, the success of microsurgery correlated with the severity of AVMs, with higher grades exhibiting lower success rates. Meanwhile, SRS offers a less invasive alternative but presents challenges such as a latency period until complete obliteration and risks associated with radiation. Embolization serves as a valuable adjunctive therapy, often utilized preoperatively to reduce bleeding risk. Combined approaches, such as embolization followed by radiosurgery, show promise in certain cases. However, treatment selection necessitates a personalized, multidisciplinary approach, considering AVM severity, location, and patient-specific factors. Post-operative care plays a crucial role in patient recovery and favorable outcomes, emphasizing the importance of monitoring and intervention to prevent complications. Despite advancements, further research is warranted to fully assess therapeutic options and ensure patient safety and efficacy. Collaboration among specialists is essential to optimize treatment strategies and enhance patient outcomes in AVM management.