Management of ruptured brain arteriovenous malformations

Brad E. Zacharia, Kerry A. Vaughan, Adam Jacoby, Zachary L. Hickman, Daniel Bodmer, E. Sander Connolly

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Intracranial arteriovenous malformations (AVMs) are a common cause of stroke in younger patients, and often present as intracerebral hemorrhages (ICH), associated with 10 % to 30 % mortality. Patients who present with a hemorrhage from an AVM should be initially stabilized according to acute management guidelines for ICH. The characteristics of a lesion including its size, location in eloquent tissue, and high-risk features will influence risk of rupture, prognosis, as well as help guide management decisions. Given that rupture is associated with an increased risk of 6 % re-rupture in the year following the initial hemorrhage, versus 1 % to 3 % predicted annual risk in non-ruptured lesions only, definitive treatment is encouraged after ICH stabilization. A rest period of 2 to 6 weeks after hemorrhage is recommended before definitive treatment to avoid disrupting friable parenchyma and the hematoma. Treatment may consist of endovascular embolization, surgical resection, radiosurgery, or a combination of these three interventions based on the lesion.

Original languageEnglish
Pages (from-to)335-342
Number of pages8
JournalCurrent Atherosclerosis Reports
Issue number4
StatePublished - Aug 2012
Externally publishedYes


  • AVM
  • Arteriovenous malformation
  • Intracerebral hemorrhage
  • Ruptured AVM


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