IV. Comprehensive treatment 1. Combination of embolization and surgery: In the past 20 years, preoperative embolization of AVM, has been accepted by neurosurgeons. Its objectives include: blocking the deep blood supply artery, occluding the high-flow arteriovenous fistula within the malformed mass, reducing the volume of the malformed vascular mass, blocking and reducing the blood flow in the malformed vascular mass, and gradually subjecting the brain tissue in the hypoperfused area around the malformed mass to a hyperperfused state after redistribution of blood flow to reduce the occurrence of bleeding and edema complications. Endovascular intervention for giant type and high flow AVM for 1 to 3 weeks followed by lesion resection is appropriate. Xiong Hui, Department of Neurosurgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine 2. Combination of embolization and radiation neurosurgery: The volume of AVM is one of the most important factors in determining the effect of stereotactic radiation therapy. Although the effect of embolization is still controversial, intravascular embolization is currently the only way to reduce the volume of AVM and adapt it to radiosurgery. Since the efficacy of neurosurgical radiotherapy takes 2 to 3 years to develop, some specific vascular structures that can increase the chance of bleeding, such as flow-related aneurysms, intravascular pseudoaneurysms, and arteriovenous fistulas, are best removed by embolization prior to radiotherapy. Radiation neurosurgery is best performed between 2 and 3 months after embolization. 3. Combination of surgery and radiation neurosurgery: Most neurosurgeons opt for radiation neurosurgery for small AVMs that remain after surgery, and surgery for AVMs that do not completely close after radiation therapy, if they are in non-functional areas. Although few neurosurgeons recommend radiation therapy before surgery, radiation therapy can occlude small vessels and facilitate surgical resection. 4. Conservative treatment: Conservative treatment can be considered for patients who are older, have only epileptic symptoms that can be controlled with medications, are located in important functional areas of the brain, are deep in the brain, or have extensive lesions . Let patients understand the natural history of AVM, try not to affect their work and life, instruct them to maintain good habits and routines, avoid overexertion and agitation, control blood pressure, give antiepileptic and other symptomatic treatment, and give hemostatic drugs to prevent bleeding if necessary.