Cerebrovascular malformations are congenital, non-neoplastic developmental abnormalities of the cerebral blood vessels. It is an abnormality in the number and structure of local blood vessels in the brain caused by the developmental disorder of cerebral blood vessels, and affects the normal cerebral blood flow. Its rupture and bleeding mainly manifests as intracerebral hemorrhage or hematoma. It is mostly seen in young people. Introduction Cerebrovascular malformation is not felt when it does not develop, unless cerebral angiography is done, so it can rarely be diagnosed before the onset. Because the malformation makes a weak link in the normal blood vessel, when a person is emotionally or otherwise stimulated to increase blood pressure (such as drunkenness, smoking, high stress, or even sex), the blood vessel breaks because it cannot withstand the sudden increase in pressure, which means it bleeds. This is when the patient presents with a severe headache, coma, and other symptoms before seeking medical attention. If there is not much bleeding, it can still be saved if it is sent to the doctor in time, otherwise it is life-threatening or eventually becomes a vegetable. Cerebrovascular malformation, also known as hemangioma, is a non-genuine tumor, which is a congenital abnormality in the development of cerebral blood vessels. There are various types clinically, among which arteriovenous malformation is more common, and according to the size of the diameter of the malformed vascular mass, it is clinically classified into large, medium and small lesions. The disease is mostly seen in males and is more common in youth. The most common symptom is rupture and bleeding of the malformed vessels, and some patients have epilepsy as the first symptom. If the hemorrhage is severe, brain herniation may occur, which is often fatal if not treated in time. There are many treatment methods for this disease, among which surgical removal of the source is the most ideal. Endovascular intervention with gamma-knife therapy is a new treatment method. There are four main types of cerebralvascular malformations: arteriovenous malformations, cavernous hemangiomas, venous hemangiomas, and cystic aneurysms. In addition, other cerebrovascular diseases that can cause hemorrhagic strokes include smoker’s disease and entrapment aneurysms. 1. Arteriovenous malformation (AVM) The clinical symptoms of AVM are important because of blood theft in addition to occupancy and compression. Due to low vascular resistance within AVM, arterial blood is shunted into the malformation, resulting in poor perfusion and chronic ischemia of normal (even distal) brain tissue, thus causing progressive neurological deficits.PET also demonstrates this phenomenon. Galen’s vein malformation is a vascular communication between the large arteries of the brain and the Galen’s vein. It can be seen in newborns and infants. Rupture and bleeding are rare because of the thick walls of the vessels. The main manifestation is due to a large amount of blood being shunted into the malformation. Neonates may have progressive high stroke volume heart failure and impaired growth, often mistaken for congenital heart disease. Intracranial vascular murmurs are evident. Hydrocephalus may develop in infancy. The mortality rate is high, with approximately 50% of deaths. Those with little blood fractionation have mild heart failure and may have recurrent transient hemiparesis. Treatment is difficult and staged surgery may be performed. 2. Congenital intracranial cystic aneurysm is less common in pediatric patients. It mainly occurs at the base of the skull in the internal carotid artery, at the anterior and posterior communicating arteries, or at the vertebrobasilar artery. The elastic and muscular layers of the artery are locally weakened and protrude as aneurysms, usually under 1 cm. The main clinical signs are acute subarachnoid hemorrhage, parenchymal hemorrhage or intraventricular hemorrhage. Before rupture, the aneurysm is often neglected and may have headache and local compression symptoms, especially cranial nerve palsy. Familial cystic aneurysms are often multiple. MRI and MRA can be helpful in diagnosis, but angiography is more reliable. The disease should also be differentiated from acquired cerebral aneurysms, such as traumatic and infectious. The disease is prone to recurrent bleeding, so it should be treated surgically. 3. Venous hemangioma is more common and occurs in the cerebral hemisphere, mostly in older children. The main manifestations are seizures, rare bleeding, and may be asymptomatic. Neuroimaging reveals vascular malformations of lmm to several cm in diameter, and about 15% have calcification. Treatment is mainly conservative and symptomatic. Spongiform hemangioma is a dense, thin-walled blood vessel found mostly in the cerebral hemisphere. They are often asymptomatic in childhood and are discovered incidentally. CT shows a mulberry-shaped lesion, and MRI shows a bright central image surrounded by a dark ring. It is common in familial cases and is dominantly inherited. Similar cavernous hemangiomas of the retina, liver, kidneys, and skin are also seen in this disease. In cases where bleeding is not critical, the patient may be observed and operated on if necessary. Etiology Vascular malformation is a developmental malformation of the intracranial vascular bed; it manifests as an abnormal increase in blood vessels in a certain area of the skull. Currently, there are four types: 1) arteriovenous malformations; 2) capillary dilation; 3) venous hemangiomas and varicose veins; 4) cavernous hemangiomas. Among them, arteriovenous malformations are the most common, accounting for more than half of them. This section describes the arteriovenous malformations. Arteriovenous malformations of the brain are most common in young people, with the highest incidence in young adults between the ages of 20 and 40, and more common in men than women. In the embryonic period, if some factor affects the normal development of the primitive cerebrovascular network, capillaries are incomplete and the arterioles and veins are directly connected to form a short circuit, which develops into cerebral arteriovenous malformation.