The treatment of vascular malformations in the brain and spinal cord depends on the type of vascular abnormality, the individual risk associated with it, the symptoms, and the patient's personal situation. Not every vascular malformation requires treatment. The goal of treatment is to reduce the risk of bleeding, alleviate existing symptoms, and maintain long-term quality of life.
Before each treatment, a comprehensive evaluation is performed using MRI, CT, and, if necessary, catheter angiography. The test results are then jointly evaluated by specialists in neurosurgery, neuroradiology, neurology, and radiation therapy. Based on this, an individualized treatment plan is developed.
More about the clinical pictureDepending on the type of vascular malformation, various treatment options may be considered:
Not every AVM requires treatment. Whether treatment is appropriate—and, if so, which type—depends on various factors, such as:
In general, the following treatment options are available:
If an AVM does not cause any symptoms and the risk of bleeding is considered low, careful monitoring may be sufficient. Checkups are conducted at regular intervals to detect any possible changes at an early stage.
In most cases, an AVM can be completely removed through surgery. In these cases, surgery provides an immediate cure for the condition and offers lasting protection against a brain hemorrhage. This treatment is performed by neurosurgeons who are highly specialized in the surgical treatment of blood vessels in the brain and spinal cord.
In this procedure, a very thin tube is guided through a blood vessel in the arm or leg to the abnormal vessels in the brain in order to selectively close off the abnormal vascular connections. In certain cases, this treatment is used immediately before surgery to reduce the risk of complications during the procedure. In certain cases, it is also used as the sole treatment, particularly when the AVM is small or when surgery would involve excessive risks due to the AVM’s location or structure. This procedure is performed by specialists in interventional neuroradiology.
During radiation therapy, the AVM is targeted with great precision. As a result, the diseased blood vessels gradually become blocked over a period of months to years. This method is particularly suitable for AVMs that, due to their location, are not accessible to other treatment methods. This treatment is performed by experts in radiation oncology
It is often advisable to combine several procedures in order to achieve the safest and best possible outcome. The decision regarding which treatment—or combination of treatments—is most appropriate is always made on an individual basis and discussed in detail with the patients.
Our goal is to treat existing symptoms and reduce the risk of a brain hemorrhage, while maintaining quality of life and independence in the long term.
Not every dAVF requires immediate treatment. Whether treatment is appropriate—and, if so, which type—depends on the individual’s risk and symptoms.
In general, the following treatment options are available:
If a dAVF does not affect the surrounding brain due to the altered blood flow and the risk of bleeding is low, careful monitoring may be sufficient. The goal of regular checkups is to detect potential changes at an early stage.
In this procedure, a very thin tube is guided through a blood vessel in the arm or leg to the fistula in order to selectively close the abnormal vascular connection. This is the most common form of treatment; in many cases, it can completely eliminate the fistula, and it is performed by interventional neuroradiologists.
Surgical treatment of dAVFs offers the best chance of a permanent cure for the condition. However, surgery is only possible and advisable for certain types of fistulas, depending in particular on the location and exact structure of the fistula. This treatment is performed by neurosurgeons who are highly specialized in the surgical treatment of blood vessels in the brain and spinal cord.
In more complex cases, catheter treatment and surgery are combined to achieve the safest and most definitive outcome possible.
Because dAVFs vary greatly in terms of risk, a careful assessment by experienced specialists is crucial. At the USZ, all cases are discussed jointly by experts in neurosurgery, neuroradiology, radiation oncology, and neurology. The goal of this individualized treatment plan is to ensure that every patient receives safe, personalized treatment that reliably reduces the risk of bleeding while maintaining their quality of life over the long term.
Not every cavernoma requires treatment. Whether treatment is advisable depends on whether symptoms are present, whether bleeding has occurred, and where the cavernoma is located.
In general, the following treatment options are available:
If a cavernoma does not cause any symptoms and the risk of bleeding is very low, routine follow-up visits are often not necessary. Whether checkups are advisable and how often they should be scheduled is always decided on a case-by-case basis in consultation with the patients.
Surgery may be appropriate in cases of recurrent bleeding, neurological deficits, or epileptic seizures that cannot be controlled with medication. The goal of surgery is to completely remove the cavernoma, thereby eliminating the risk of further bleeding and alleviating symptoms. This treatment is performed by neurosurgeons who are highly specialized in the surgical treatment of blood vessels in the brain and spinal cord.
The decision on whether to treat a cavernoma is always made on a case-by-case basis. The location in the brain or spinal cord, as well as the existing symptoms, play a particularly important role in this regard.
At the USZ, all cases are evaluated jointly by experts from various fields. The goal is to work with patients to choose a treatment that is safe and focuses on long-term quality of life.
Preparation depends on the planned procedure. Before treatment begins, the necessary tests are performed and the results are discussed in detail. The treating specialists will provide individualized information about the necessary preparatory measures.
After treatment, clinical and imaging follow-ups are conducted depending on the condition and type of therapy. These are used to monitor the success of treatment and detect any changes at an early stage. At the USZ, patients receive long-term care from a specialized team.
Director of Department, Department of Neurosurgery
Senior Physician, Department of Neurosurgery
Senior Physician, Department of Neurosurgery
Senior Attending Physician, Department of Neurosurgery
Attending Physician, Department of Neurosurgery
Director of Department, Department of Neuroradiology
Resident, Department of Radiation Oncology
The USZ offers specialized clinics for vascular malformations of the brain and spinal cord. There, test results, risks, and possible treatment options are discussed in detail. Referrals are typically made by the attending physician.
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University Hospital of Zurich
Department of Neurosurgery
Frauenklinikstrasse 10
8091 Zurich
The treatment of vascular malformations requires extensive experience and close collaboration among various medical specialties. At the USZ, all cases are reviewed jointly by specialized interdisciplinary boards. This makes it possible to treat even complex vascular malformations on a case-by-case basis and in accordance with the latest scientific findings.
The USZ is one of the few centers to offer all established treatment methods at a single location—ranging from microsurgical procedures to endovascular catheter procedures and radiosurgery. Modern technologies such as high-resolution imaging, neuronavigation, intraoperative ultrasound, ICG angiography, and neuromonitoring support precise and safe treatment.
The USZ is also one of the leading centers for the treatment of vascular malformations in the brain and spinal cord and was once again recognized as Switzerland’s top-ranked neurosurgery department in the “World’s Best Specialized Hospitals 2026” ranking.
