Roles of Angiogenesis and Vascular Remodeling in Brain Vascular Malformations

Recent advances in understanding of angiogenesis and vascular remodeling have been shedding a new light into pathophysiology of vascular malformations in the brain, and new treatment strategies have been emerging. Generally, vascular malformations in the brain include cerebral arteriovenous malformations (AVMs), cavernous malformations, and dural arteriovenous fistulae (DAVF). Although their genesis is not well understood, there is a growing evidence suggesting that some of these lesions undergo active angiogenesis and vascular remodeling in the adult life. This new concept—active angiogenesis and vascular remodeling in intracranial vascular malformations—is opening a new clinical paradigm in which pharmacological interventions are proposed to stabilize these abnormal blood vesels and prevent further growth or hemorrhage.