**2.5 Palliative embolization**

Although there is significant debate on the management of unruptured arteriovenous malformations, intractable seizures or intractable headaches may dictate further treatment rather than medical management. Embolization can decrease the severity of these symptoms by theoretically reducing the steal phenomenon and venous hypertension [35, 36]. Embolization of the meningeal supply can relieve intractable headaches. Resolution of trigeminal neuralgia after embolization has been reported [37]. One must always consider risk-benefit balance when considering embolization for symptom relief because partial treatment of large AVMs by embolization or surgery may increase the risk of intracranial hemorrhage [27]. On the other hand, Meisel et al. [38] found that partially embolized AVMs have a lower risk of hemorrhage than the risk expected during the natural course of an untreated AVM.
