The procedure for the surgical treatment of combined arteriovenous malformations and arterial aneurysms of the brain

: To choose the optimal surgical treatment, the follow-ups of 25 patients with arteriovenous malformations (AVMs) concurrent with arterial aneurysms who had been surgically treated were considered. Twenty four patients experienced spontaneous subarachnoidal hemorrhage, 16 of them were repeated and multiple. The accurate diagnosis of the source of bleeding was associated with objective difficulties. With allowance for intraoperative findings. AVMs caused hemorrhage in 14 (58%) cases, aneurysms in 6 (25%). AVMs and aneurysms in 4 (17%). Thirteen (52%) patients were operated on AVMs and aneurysms in one or two steps, 5 had operations only on aneurysms, 7, on AVMs alone. Taking into account ruptures and higher sizes of aneurysms after AVM dissection, it is concluded that it is necessary to immediately exclude saccular bifurcating aneurysms irrespective of the cause of bleeding. Possible variants of policy decisions are dealt with, by taking into account the specific features of the location of AVMs and aneurysms-the sources of hemorrhage. One-stage surgical interventions into AVMs and aneurysms are recognized to be optimal.