Cerebral Vascular Malformations

Vascular malformation is a frequent cause of intracranial hemorrhage. High-flow vascular malformation includes arteriovenous malformation (AVM) and arteriovenous fistula (AVF), while low-flow malformation includes cavernous malformation (CM), developmental venous anomaly (DVA), and capillary telangiectasia. AVM consists of a nidus connecting the feeding artery and draining vein and can be classified based on its size, venous drainage, and involvement of eloquent brain. In comparison, AVF is a direct high-flow shunt between the artery and vein without a nidus. Dural AVFs with retrograde cortical venous drainage have more aggressive clinical course and can lead to a spectrum of hemorrhagic or non-hemorrhagic complications. Cavernous malformation is an angiographically occult lesion that occasionally causes hemorrhage and seizure, while developmental venous anomaly is usually an incidental finding on imaging but can occasionally thrombose and cause venous infarction.