Current Issue January 2012 | Vol. 23, No. 1

Current Topic

Cranial Arteriovenous Malformations (AVMs) and Cranial Dural Arteriovenous Fistulas (AVFs)Guest Editors: Rafael J. Tamargo and Judy Huang

Brain arteriovenous malformations (AVMs) and dural arteriovenous fistulas (DAVFs) are rare and formidable lesions. The prevalence of AVMs in modern radiographic series is only about 0.2%.1 The prevalence of DAVFs---which are characteristically difficult to image on CT or MRI and therefore difficult to identify in screening studies---is even more challenging to ascertain, but DAVFs are probably even less common than AVMs.2 By contrast, intracranial aneurysms have an estimated prevalence of about 3%,3 which makes aneurysms 15 times more common than AVMs. The rarity of AVMs and DAVFs has frustrated any attempts to study their treatment in prospective randomized trials.4 Over the past century, however, neurosurgeons, neurointerventional radiologists, and radiosurgeons have made steady progress in the diagnosis and treatment of these complex lesions. This progress is particularly impressive when one considers that current epidemiological and surgical series of AVMs comprise only a few hundred patients. By contrast, contemporary aneurysm series include thousands of patients. Therefore, our current knowledge about AVMs and DAVFs is based and will continue to evolve on empirical evidence derived from a limited number of patients.