Q)  What is a follow-up protocol after brain AVM treatment?

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A) If the AVM is completely occluded by embolization or completely removed by surgery, no need for long term follow up imaging.

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B) If the patient has stereotactic radiosurgery (SRS), it is recommended by Ding et al.(from university of Virginia, Charlottesvile, VA, USA) to check MRI brain and MRA brain every 6 months for 2 years and then rechecking annually to detect any long-term complications from SRS.  Please see our figures below.

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Reference

1)    Ding D, Starke RM, Sheehan JP. Radiosurgery for the management of cerebral arteriovenous malformations. Handb Clin Neurol. 2017;143:69-83.

2)    Yen CP, Matsumoto JA, Wintermark M, Schwyzer L, Evans AJ, Jensen ME, Shaffrey ME, Sheehan JP. Radiation-induced imaging changes following Gamma Knife surgery for cerebral arteriovenous malformations. J Neurosurg. 2013 Jan;118(1):63-73.

3)    Ilyas A, Chen CJ, Ding D, Buell TJ, Raper DMS, Lee CC, Xu Z, Sheehan JP. Radiation-Induced Changes After Stereotactic Radiosurgery for Brain Arteriovenous Malformations: A Systematic Review and Meta-Analysis. Neurosurgery. 2018 Sep 1;83(3):365-376.

4)    Singer RJ, Ogilvy C, Rordorf G. Brain arteriovenous malformations. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on November 01, 2020.)

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