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rarely familial) Embryology ? First half of third week of gestation ?epiblastic cells migrate to form mesoderm ?mesodermal cells differentiate to arterial and venous vessels on the surface of the embryonic nervous system Embryology ? First half of third week of gestation ?epiblastic cells migrate to form mesoderm ?mesodermal cells differentaite to arterial and venous vessels on the surface of the embryonic nervous system ? Seventh gestational week ?vessels sprout branches amp。n ?eventually connect arterial and venous systems by around the twelfth week Pathology amp。 Pathophysiology ?absence of normal capillary system ?usual function displaced ?asymptomatic at birth ?vessels change with time ?may develop aneurysms ?parenchymal changes within and around the lesion Pathology amp。 Martin Grading System Criteria Score Size of Nidus Small (3cm) 1 Medium (36cm) 2 Large (6cm) 3 Eloquence of Adjacent Brain No 0 Yes 1 Deep Vascular Component No 0 Yes 1 Treatment Options ?Surgical Resection Treatment Options ?Surgical Resection ?Endovascular Embolisation Treatment Options ?Surgical Resection ?Endovascular Embolisation ?Stereotatic Radiosurgery Treatment Options ?Surgical Resection ?Endovascular Embolisation ?Stereotatic Radiosurgery ?Multimodal Therapy Treatment Options ?Surgical Resection ?Endovascular Embolisation ?Stereotatic Radiosurgery ?Multimodal Therapy ?Conservative Management