Just logged in and saw your post from last week. My 17yr old son has a grade 4 left occipital lobe AVM. We ended seeing Dr. Lawton at UCSF before he went to Barrow Institute, Dr. Spetzler at Barrow before he retired as well as our local Oregon Heath Science university hospital…which actually is really competent with AVMs. After ruling out craniotomy due to vision loss risk we were faced with the same 2 options you are looking at. For us we went with Gamma Knife for a couple of reasons (keep in mind this is our situation and yours maybe different)
Gamma Knife has more resolution than cyberknife so the edge between treated and untreated area of your brain is smaller and should be a lower risk of a tumor occurring in the “partially” treated area over time. This was important to us given my son is young and thus would have more time for this to develop over time. It is a very small risk but a non-zero risk.
The UCSF and Barrow institute doctors recommended GK with no embolization and the OHSU doctors recommended Cyberknife and were considering pre-embolization as well. When I studied the pre-embolization I learned there is a chance the glue could pass through the target site and create a stroke in a smaller blood vessel…once again a small risk but when combined with the fact that the GK recommendations were to not Embolize I felt the GK route was a better option for our son.
We are just over a year since my son’s second GK treatment (they needed to do 2 treatments due to the size of the AVM) and he is doing great. We had one check a few months ago and some of the smaller blood vessels were already gone but will take another 2 years for the treatment to do it’s job.
I like the recommendation to get a remote assessment done by the Barrow institute. In all cases I would ask all your doctors to tell you the pros/cons of both options and then you can integrate all the responses on your own.
hope this helps and good luck!