Stony Brook is Your Vascular Malformation Expert
Our experienced, highly trained team, led by Dr. David Fiorella, uses all the latest diagnostic tools and performs all the latest minimally invasive procedures for arteriovenous fistula (AVF) and for arteriovenous malformation (AVM.)

Our multidisciplinary expert team offers both in person and telemedicine consultations for the treatment of all cerebrovascular disease processes. Contact us for a consultation:

Cerebrovascular Neurosurgery:  (631) 444-1213
Endovascular Neurosurgery: (631) 444-1213
Vascular Neurology (Stroke Neurology): (631) 444-2599

What is a Vascular Malformation?
​​​​​​​High-flow vascular malformations occur when there is an abnormal connection or “short circuit” between the arteries and veins of the brain or spinal cord. This “short circuit” allows the rapid flow of high pressure arterial blood flow directly into the venous structures, which are not structured to accommodate high flows and high pressures. This creates a potential for the malformation to rupture (bleed). The “short circuit” can also cause high venous pressures, which can result in brain swelling (i.e., brain edema) leading to seizures, headaches and/or stroke-like symptoms. Most people who have a vascular malformation of the brain or spinal cord are born with them, but they can occasionally form later in life. The two of the types of high-flow vascular malformations involving the brain and spinal cord are dural arteriovenous fistulae (dAVF) and arteriovenous malformations (AVMs).

  • Arteriovenous Fistula (AVF): An abnormal connection between arteries supplying the coverings of the brain and/or spinal cord and the veins. These malformations are usually acquired later in life, although they can occasionally occur in children. At Stony Brook Medicine, most all of these types of malformations can be cured through minimally invasive procedures performed through the inside of the blood vessels with minimal recovery time.    
  • Arteriovenous Malformation (AVM): An abnormal connection or entanglement between arteries supplying the brain and/or spinal cord and veins. AVMs are congenital, meaning that patients have these malformations from birth. While present from the time of birth, patients often times do not become symptomatic until adulthood. Headaches, seizures, and sometimes brain bleeds can be the first presenting symptoms of brain AVMs. At Stony Brook Medicine, brain AVMs can sometimes be cured altogether through minimally invasive procedures performed through the inside of the blood vessels. open surgery or radiosurgery. Other times, we treat these malformations using a combination of a minimally invasive (embolization) procedure, open surgery or radio surgery.