Cerebral arteriovenous malformation is one of the most common types of cerebrovascular malformations, which is located in the superficial or deep part of the brain. Cerebral arteriovenous malformations are composed of arteries and veins, some of which contain aneurysms and venous aneurysms. Cerebral arteriovenous malformations are caused by large blood-supplying arteries that supply blood to the brain, and large draining veins that return blood to the brain, and their sizes and shapes are varied. They are mostly found in the frontal lobe and parietal lobe, while others such as temporal lobe, occipital lobe, intraventricular, thalamus, cerebellum and brainstem also occur. Cerebrovascular malformations are categorized according to the size of the AVM mass: at present, the Drake (1979) standard is often used to classify them into: ①small, with a maximum diameter of <2.5cm; ②medium, with a maximum diameter of 2.5~5.0cm; ③large, with a maximum diameter of >5cm, such as the maximum diameter of>6cm, which can be classified as the giant type. Classification according to the angiographic pattern: Parkinson et al. (1980) divided AVM into: ① multi-unit type with multiple arteries and multiple venous drainage, vascular mass with multiple arteriovenous fistulae, the most common, accounting for 82%; ② a single-unit type, a blood-supplying artery and a drainage vein composed of a fistula small AVM, accounting for about 10%; ③ linear, one or several blood-supplying arteries directly into the large veins or venous brain; ③ linear, one or several blood-supplying arteries, the blood-supplying arteries directly into the large veins or venous brain. Directly into the brain large veins or venous sinuses, accounting for about 3%; ④ composite, intracranial and extracranial arteries are involved in blood supply, reflux can also be through the intracranial and extracranial venous sinuses. Classification according to the three-dimensional form of AVM: Shi Yuquan (1982) on 65 cases of infusion of plastic casting three-dimensional model of AVM according to the morphology of classification, divided into: ① varicose type, thickening and expansion of the cerebral arteries and cerebral veins around a group, there are many arteriovenous fistulae in the group. This type is the most common, accounting for 65% of cases; ② Broom-type arteries are like dendrites, and their branches anastomose directly with the veins; ③ Arteriovenous aneurysm type, with enlarged arterioles and veins in the form of a balloon, and the whole AVM is like a ginger tuber; ④ Mixed type, with the three types mentioned above coexisting in a single lesion. The latter three types each account for about 10% of the cases. The grading method formulated by Spetzler and Martin in 1986 rated the size (maximum diameter), location and draining veins of AVMs as the main indexes as O~3 points, and then divided into 6 grades, in which the location is in the neurological function areas, such as sensory and motor cortical areas, language center visual center, thalamus, internal capsule, deep cerebellum, cerebellar peduncle and its adjacent areas, and 1 point; such as the obvious Involving the brainstem and hypothalamus is directly categorized into level 6; other parts of the 0, the sum of the three index scores, that is, the level of AVM. This kind of grading method is widely used in the international arena, and is similar to the Shih’s grading method. Clinical manifestations often manifested as epilepsy and spontaneous cerebral hemorrhage, may have incomplete paralysis of limbs, some cases have increased intracranial pressure, similar to brain tumors, larger cerebral arteriovenous malformations, sometimes causing intracranial stasis of the symptoms of cranial orbital auscultation sometimes heard vascular murmurs. Cerebral arteriovenous malformation is the most common type of cerebrovascular malformation, located in the superficial or deep part of the brain. Due to the theft of blood from the malformed blood vessels, the blood supply to the brain tissues around them is reduced, and thus the symptoms of blood theft appear. 1, young people with a history of spontaneous subarachnoid hemorrhage or intracerebral hemorrhage, usually with headache, seizures and weakness of one side of the limbs, should be more suspected of this disease, which often has a sudden onset and has a causative factor. 2.Hemorrhage patients should be examined for signs of meningeal irritation, intracranial murmur and signs of neurological deficits due to blood theft. 3.Lumbar puncture to measure intracranial pressure; to know whether the cerebrospinal fluid is bloody or not and make red blood cell count. 4.Cranial CT can see localized mixed density area, irregular enhancement area can be seen after enhancement, and tortuous dilated blood vessels can be seen, but also can be found in hematoma and cerebral atrophy, localized calcification and other secondary changes. 5.Cranial MRI or MRA can be seen in the lesion area without signal and tortuous vascular shadow, MRA can be seen in the blood-supplying arteries, malformed vascular clusters and draining veins. 6.Transcranial ultrasonography (TCD) shows that the blood flow velocity of large arteries in the blood-supplying region increases and the beat index decreases. 7.Selective cerebral angiography (DSA) can understand the site of AVM, blood supply artery, the size of malformed vascular mass and draining veins, and whether it is accompanied by aneurysm, venous aneurysm, arteriovenous fistula and cerebral blood theft. If necessary, external carotid arteriography should be added to know whether the external carotid artery is involved in blood supply. Differential diagnosis should be differentiated from cavernous hemangioma, epileptic G, glioma with rich blood supply, venous vascular malformation and smog disease. Surgical treatment now mostly adopts microscopic neurosurgical techniques to remove the diseased vascular mass. In case of combined intracranial hematoma, urgent surgery is required, and the lesion should be removed at the same time if possible. 2.Intravascular embolization treatment for lesions deep, located in important functional areas or high blood flow lesions, it is appropriate to carry out embolization treatment. Commonly used embolizing agents are NBCA and silk, wire or particles, but simple embolization can only cure a small portion of the lesion, which can be partially embolized and then microsurgically resected. 3.Stereotactic radiosurgery treatment, i.e. X-knife or γ-knife, is non-invasive, but expensive and slow to show results, applicable to deep lesions with a diameter of less than 3cm or residual lesions after surgery and embolization. 4, Gamma Knife treatment of cerebral arteriovenous malformation Gamma Knife treatment effect is certain, one year after the closure rate of more than 80%. According to the past experience, vascular nest diameter is less than 4 centimeters, the efficacy is reliable, and the side effect reaction is very small. However, some cases of malformed vascular clusters with a large diameter, but also located in the important functional areas, should not be performed surgical treatment, endovascular treatment of recanalization rate is high, and often need multiple treatments, which provides an opportunity for gamma knife treatment, with the accumulation of experience in gamma knife treatment of large lesions, the continuous improvement of the gamma knife technology, the gamma knife can be positioned through the thermoforming membrane, multiple treatments, so that the giant cerebral arteriovenous malformations of the gamma knife treatment has become Gamma knife treatment of giant cerebral arteriovenous malformation has become possible. 5.Non-surgical treatment is suitable for huge type located in important functional areas, with subarachnoid hemorrhage without hematoma, the measures are: ① Avoid triggering factors, such as violent emotional fluctuations, prohibition of smoking and alcohol. ② Prevent and control seizures. ③Prevent rebleeding. ④ Symptomatic treatment V. Prognosis Most of the patients have a good clinical outcome. Microsurgical resection for Spetzler and Martin grading 1, 2, 3 non-functional area can get a good prognosis; preoperative embolization combined with microsurgical resection treatment for functional area, deep in the 2, 3, 4 can get a better therapeutic effect.