The following paper presents analysis of 182 cases of arteriovenous malformations treated surgically at the Neurosurgical Department of the Johannes Gutenberg-Universität Mainz, FRG. Although the behavior of AVMs remains unpredictable, morphological features of AVMs have an important bearing on their clinical presentation, especially the mode of bleeding.

The indication for surgery in spontaneous intracerebral hematoma is given when, in spite of the administration of dexamethasone in high dosage, an improvement of the initial neurological symptoms could not be observed, or if a worsening is seen. With the help of CT the size of the hematoma could be controlled so that if in comparison to initial findings an increase in mass displacement or herniation is observed, surgery should be performed immediately. In cases of deep coma with vegetative unstable states, as well as in cases of bleeding into the basal ganglia, surgery is contraindicated.