Neurosurgery
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Complete surgical resection of arteriovenous malformations (AVMs), documented by postoperative angiography, is generally felt to represent cure, obviating the need for long-term follow-up imaging. Although AVM recurrence has been reported in the pediatric population, this phenomenon has only rarely been documented in adults. Recurrence after treatment solely with embolization, however, has been reported more frequently. Thus, patients undergoing multimodal therapy with surgery following preoperative embolization may also be at higher risk for recurrence. ⋯ AVM recurrences in the adult population may have a multifactorial origin. Although deep venous drainage and diffuse nidus are clearly risk factors, preoperative embolization may also be a contributing factor with the potential for recurrence of unresected but embolized portions of the AVM. Follow-up angiography at 1 to 3 years appears to be warranted.