From asymptomatic expansion to hemorrhagic crisis: contemporary perspectives on intraosseous arteriovenous malformations of the jaws.

Intraosseous arteriovenous malformations (IOAVMs) of the jaws are rare high-flow vascular lesions that may remain clinically silent for prolonged periods yet can present suddenly with severe, life-threatening hemorrhage, most often in the setting of dental or surgical intervention performed before diagnosis. This narrative review presents evidence from case reports and case series in English, with descriptive analysis of demographic features, clinical presentations, and imaging findings. The mandible is the most common site of involvement, and nonspecific clinical and radiographic findings usually delay the diagnosis; angiography is, therefore, essential for establishing the diagnosis and assessing the lesion's extent, flow dynamics, and collateral circulation. Management is mainly selective endovascular embolization, either definitive or preoperative adjunctive treatment, before surgical resection; however, incomplete embolization, collateral recruitment, recurrence, and delayed hemorrhage remain significant concerns. These findings underscore the need for high clinical suspicion, timely angiographic evaluation, multidisciplinary collaboration, more consistent reporting, and longer follow-up to define durable management strategies.