McCormick in 1966 and Russell and Rubenstein described four types of vascular malformations, and this is now accepted as the current nomenclature. [62-64] Cerebrovascular malformations are classified according to their histopathologic features as : arteriovenous malformation (AVMs), venous angioma, cavernous malformation, and capillary telangiectasia. The focus of this chapter is on true AVMs. A possible fifth category is a direct fistula, or arteriovenous fistula (AVF). These conditions are regarded as acquired lesions involving single or multiple dilated arterioles that connect directly to a vein without a nidus. They are high-flow, high-pressure lesions that have a low incidence of hemorrhage (examples include vein of Galen aneurysmal malformation, dural AVF, and carotid cavernous fistula). [62-64]