Vascular Malformations of the Brain Treatments

UT Southwestern treats every kind of vascular malformation of the brain, including arteriovenous malformations (AVM), dural arteriovenous fistula (DAVF), and the rarest types of these abnormalities. Physicians from throughout Texas refer their patients to us for the most comprehensive treatment options available.

Because we’re an academic medical center, UT Southwestern offers access to new treatments that may not be available at other facilities. We evaluate the latest treatments, offering them to patients only when we feel they are safe. And we don’t need to refer you anywhere else, because every available option for the best treatment is available here.

Treatment Options

Evaluation is the first step in determining the best treatment options for your vascular malformation of the brain. The initial evaluation helps us establish its type, size, and location in the brain, so we can make an informed decision as to the type of treatment we’ll recommend. 

When you see one person on our team, you’re effectively seeing the whole team: Every patient’s case is reviewed by all our cerebrovascular specialists before any treatment begins.

Interventional treatment options may include one or more of these techniques:

  • Open surgery – Open surgery is the longest-established treatment for vascular malformations of the brain. In open surgery, one of our neurosurgeons performs a craniotomy, in which a portion of the skull is removed to allow access to the vascular malformation. The specific technique depends on the type of malformation, but the goal is complete removal of the malformation in an attempt to eliminate any future problems.
  • Endovascular embolization – This procedure involves injecting liquid glue, or sometimes small metal coils, via a catheter to block the blood supply. This technique can help eliminate or shrink the malformation. A neurointerventional radiologist inserts the catheter through the groin and threads it up into the arteries in the brain leading to the vascular malformation.

Our experienced neurosurgeons now have the ability to combine endovascular and surgical procedures in the same operative suite. This hybrid operating room allows pinpoint accuracy when locating the vascular malformation and also allows the surgeon to confirm complete treatment without transferring the patient to another area of the hospital. New treatments designed for hybrid operating theaters allow more direct treatment in areas where standard access is more dangerous.

  • Stereotactic radiosurgery – This treatment involves directly targeting a single treatment of high-energy radiation delivered by a linear accelerator (or Gamma Knife or CyberKnife) to cause the abnormal vessels to close over time. The precise targeting of radiosurgery minimizes damage to surrounding areas of the brain. Performed by a team that includes a cerebrovascular neurosurgeon, a radiation oncologist, and a radiation physicist, radiosurgery is a less common form of treatment. But because we also treat a large number of cancer patients who receive stereotactic radiosurgery, our experts are highly skilled at performing it.

In some cases, immediate treatment may not be necessary or recommended because the vascular malformation may not be in danger of rupturing or bleeding, or there are no symptoms, or surgery may be considered too dangerous. But that doesn’t mean there aren’t other options: Our team will continue to observe the vascular malformation, performing regular imaging tests and discussing any changes with you as they develop.

Request an Appointment

To schedule an appointment with a vascular malformations specialist at UT Southwestern’s facilities in Dallas, or to learn more about our services, request an appointment or call 214-645-8300.