My 43 yr old daughter has a deep seated inoperable 3.8 cm sized AVM which bled

December 3, 2015 by   |   Leave a Comment

Question from Bet:

My 43 yr old daughter has a deep seated inoperable 3.8 cm sized AVM which bled on 6/10. Could treatment be just as effective by only using radiation, as opposed to both an embolization/radiation combination?

Dear Bet,

Your question about AVM’s is a relatively common one.  AVM’s which have bled do require treatment.  Gamma Knife surgery can be used to treat many deep seated AVM’s.  The Gamma Knife optimal treats AVM’s that are 3 cm in mean diameter.  At our center, we have demonstrated 80% obliteration of AVM’s less than or equal to 3 cm in mean diameter.

For AVM’s that are larger than 3 cm, Gamma Knife surgery can be employed alone or in conjunction with embolization.  It is unlikely that embolization alone would obliterate a large AVM.  If embolization is done prior to Gamma Knife surgery, it is important that the physician performing the embolization understands that radiosurgery will follow and embolizes only compact, contiguous regions of the AVM nidus.

AVM’s that are large an inoperable can also be treated in a 2 staged process with Gamma Knife surgery.  More information about this is available on our web site.  http://www.healthsystem.virginia.eduavmL.cfm

The optimal treatment process for large AVM’s is best decided by an experienced, multidisciplinary team comprised of physicians with Gamma Knife, embolization, and surgical resection experience. 

If you would like to have your daughter’s case reviewed, please send me the information listed on our web page.


Jason Sheehan



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