The prognosis and treatment of arteriovenous malformations of the brain

INTRODUCTION Despite the passage of a century and a half since the fi rst description of a brain arteriovenous malformation (AVM) (Rokitansky 1846), and although the imaging of brain AVMs advances relentlessly (Fig. 1), we still need adequate studies of brain AVM prognosis and reliable evaluations of their treatment. Prospective, populationbased studies of brain AVM prognosis are underway (Al-Shahi et al. 2003; Stapf et al. 2003b), and a randomised controlled trial (RCT) of their treatment is planned (http://www.arubastudy. org), so this review aims to inform your management of adults with brain AVMs whilst the results of these studies are awaited. This review is based on two systematic reviews updated to 1 January 2005 (Al-Shahi & Warlow 2001; AlShahi & Warlow 2005), an authoritative narrative review (The Arteriovenous Malformation Study Group 1999) and North American practice guidelines (Ogilvy et al. 2001).