What is the best management of an unruptured Spetzler Martin grade 3 arteriovenous malformation in a young patient?

This is a complex question and first and foremost requires and understanding of the natural history of an AVM.

Natural history of cerebral arteriovenous malformations: a meta-analysis

Nine natural history studies with 3923 patients and 18,423 patient-years of follow-up were identified for analysis. T...