Acute management of ruptured arteriovenous malformations and dural arteriovenous fistulas.

Arteriovenous malformations of the brain (AVMs) are a major cause of stroke in young, healthy individuals and present multiple diagnostic and therapeutic challenges, particularly in the acute setting. Although the flow hemodynamics, biology, epidemiology, and natural history of AVMs have been extensively studied, little data have been published on AVM surgery in the acute setting, and acute surgery has been claimed to possibly increase the risk of persistent neurological deficits. Although it is usually preferable to defer AVM surgery for a few weeks or months, acute surgical (open and endovascular) management is essential in specific clinical and radiological settings.