ABSTRACT
Stereotactic radiosurgery has become an important and widely used treatment technique for the management of cerebral arteriovenous malformations (AVMs). The first AVM radiosurgery procedure was performed by Kjellberg in 1965 using protons (P. Chapman, personal communication). He did not perform another procedure until years later, after Steiner et al. had reported their initial case (1). Since that time, ongoing analyses of results have led to refinements in technique and a better understanding of both the vascular malformation response and the normal surrounding brain response (2-16). Increased knowledge has led to improved clinical results. Although radiosurgery is a minimally invasive technique, it is not risk-free. Most patients will enjoy long-term survival if their AVM is obliterated. Therefore, both short-and long-term outcomes after radiosurgery must be evaluated rigidly. In this chapter, we discuss the results from our 17-year experience with the radiosurgical treatment of patients with AVMs at the University of Pittsburgh, and we discuss the continuing and future role of radiosurgery in AVM management.
