Acta Neurochir (2015) 157:299–301 DOI 10.1007/s00701-014-2279-2

LETTER TO THE EDITOR - VASCULAR

Management of cerebral arteriovenous malformations with associated aneurysms: a proposed multimodality treatment algorithm Dale Ding

Received: 7 November 2014 / Accepted: 10 November 2014 / Published online: 25 November 2014 # Springer-Verlag Wien 2014

Dear Editor, I have read, with interest, a recently published article in Acta Neurochirurgica by Platz et al. [27] titled ‘Frequency, risk of hemorrhage and treatment considerations for cerebral arteriovenous malformations with associated aneurysms’. The authors report a retrospective cohort study of 59 patients harboring cerebral arteriovenous malformations (AVMs) with AVM-associated aneurysms (AAAs), which represented 27 % of their overall institutional AVM experience. AVMs with AAAs were more likely to present with hemorrhage (p=0.025) and have infratentorial location (p=0.001). A total of 92 AAAs were detected in the study cohort (mean 1.6, range 1–5 AAAs per patient). The AAA was the source of hemorrhage in 94 % of cases. Ruptured AAAs were significantly larger (p