Patient: Long-term headache, insomnia, fainting fern once two years ago Laboratory tests: right temporal middle cerebral artery travel area can be seen in the right side of the tortuous blood vessels, and radiation-like flowing vascular shadow; no obvious abnormal signal foci in the brain parenchyma, no changes in the ventricular system, no abnormalities in the brain pool, brain sulcus, midline structure in the middle. Ken asked the doctor to guide how to treat Zhao Guangyu, Department of Neurosurgery, Shandong Provincial Hospital: Cerebrovascular malformation (AVM) is a congenital cerebrovascular disease, which can cause symptoms such as intracranial hemorrhage, normal brain tissue ischemic attack (TIA), or epilepsy due to direct communication between arteries and veins in the brain causing arteriovenous short circuit. It is a common cerebrovascular disease. You have already had an MRI for a preliminary diagnosis of cerebrovascular malformation, and further tests can be performed with a whole brain angiogram (DSA) to clarify the relationship between the blood supplying arteries and draining veins and the important neural structures. In terms of treatment, AVM can be treated with embolization, craniotomy, and r-knife treatment, all of which are based on cerebral angiography. Embolization is very traumatic and has the advantage of quick recovery after surgery, but the disadvantage is high cost; craniotomy can be a one-time cure, but it is very traumatic, dangerous and has many postoperative complications. r-knife has the advantage of no surgery, but it is slow and long, and is mostly used as an adjunct to other treatments. According to what you said, do cerebral angiography first and then make a decision.