Q) What is a follow-up protocol after brain AVM treatment?
A) If the AVM is completely occluded by embolization or completely removed by surgery, no need for long term follow up imaging.
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.
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.)