It is truly an honor to have been asked to write a foreword to this truly comprehensive and up-to-date text on arteriovenous malformations (AVMs) of the brain and spine, which has been a favorite topic of mine throughout my career. Clearly, much has been written on this topic and there have been excellent textbooks, frequently on the larger topic of cerebrovascular surgery, which have described in detail one or another aspect of the management of these vascular lesions. However, I know of no other work that “puts it all together” with the most modern available information on this topic. The first section on development, anatomy, and physiology opens with an excellent chapter by Lawton and his colleagues with beautiful drawings depicting the embryologic development of the vasculature of the nervous system. This section ends with a very good summary of what is known to date about the natural history of AVMs of the brain by Laakso and Hernesniemi. This section also includes an excellent discussion of spinal vascular anatomy by Singh and Gobin. The second section on evaluation and treatment considerations, such as neuromonitoring and neuroanesthesia, concludes with an excellent chapter on the classification of brain and spinal AVMs and fistulae by Du and her colleagues. The next section, on surgical approaches, includes chapters by several of the most experienced cerebrovascular groups, including a beautifully illustrated chapter on the surgery of spinal AVMs and fistulae by the senior editor of this book and his group at the Barrow Neurological Institute. The last section, which includes endovascular and radiosurgical treatments of AVMs, is particularly comprehensive and includes an interesting chapter on the difficult and controversial topic of “palliative” treatment of those lesions that cannot be eliminated with conventional methods. The book concludes with a thoughtful comment by Russin and Spetzler on the ARUBA trial and its impact and possible consequences.
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