Arteriovenous malformations (AVM) and arteriovenous fistulas (AVF) differ from all other pathology affecting the central nervous system by their high-flow arteriovenous shunts. Permanent occlusion of these shunts is the essence and the challenge of therapy. Endovascular therapy and radiosurgery became accepted alternatives or adjuncts to surgery. In many instances the choice of the primary therapeutic modality is not clear and arguments can be found for several options. However, microsurgery, endovascular therapy and radiosurgery differ very much with regard to invasiveness, length of stay at the hospital but also residual risk after therapy. The emerging treatment concepts are the object of this book. The result is a unique structured presentation of AVM and AVF therapy.
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General considerations and review of the literature (R. Schmid-Elsaesser): Arteriovenous malformations of the brain; Dural arteriovenous fistulas of the brain; Spinal arteriovenous malformations; References.- Classifications (H.-J. Steiger): Theoretical considerations; Pathoanatomical classification; Surgical classifications; Angioarchitecture of cerebral arteriovenous malformations; Angioarchitecture of cranial dural arteriovenous fistulas; Topographical classification of cerebral arteriovenous malformations; Topographical classification of cranial dural arteriovenous fistulas; Classification of spinal arteriovenous malformations; References.- Results of surgery, embolization, and radiosurgery: A detailed literature review (H.-J.Steiger): Results of pure surgical treatment; Results of endovascular treatment; Results of radiosurgical treatment; Endovascular embolization combined with surgical resection; Embolization combined with radiosurgery; Surgery combined with radiosurgery; References.- Surgical principles (H.-J. Steiger): Introduction; General principles of surgery for AVMs and dAVFs; Peri- and intraoperative management; Special principles of cerebral AVMs; Specific principles of cranial dAVFs; Surgical principles of spinal AVMs; References.- Endovascular interventional principles (H. Bruckmann, H.-J. Steiger): Introduction; General principles of endovascular embolization; Peri-interventional management; References.- Gamma Knife radiosurgery for cerebral AVMs (B. Wowra): Introduction; The dose planning strategy includes a prospective risk estimation; Personal experience using the LGK in Munich; Discussion of the therapeutic profile of radiosurgery compared to microsurgery and embolization; Conclusion; References.- Surgical and combined endovascular and surgical case presentations (Cases S-1 to S-40) (H.-J. Steiger, R. Schmid-Elsaesser, A. Muacevic, H. Bruckmann).- Exclusively endovascular case presentations (Cases E-1 to E-5) (R. Schmid-Elsaesser, H.-J.Steiger).- Radiosurgical case presentations (Cases R-1 to R-11) (B.Wowra)
