My wife suffered from her second stroke this past August and her neurosurgeon recommends we get aggressive in treating her AVM, which is located in the brainstem (pons area). The hospital our nuerosurgeon is affiliated with has the Novalis machine, which I understand is a linear acceleration type of machine for radiosurgery. Her scheduled appt for this is next week. She's had two other radiosurgeries in the past attempting to abliterate her AVM, but with no luck. The difference between those two treatments and this one is her nurosurgeon kept the Gy's low (I beleive around 14)for the first two. This time he wants to turn it up because he feels if there is any "overspray" it will most likely damage the area of the brainstem that was already damaged by her last stroke. The result of this stroke left her with hemiparesis to her right side. She basically has no independence, because her balance center was damaged. She can walk with a walker if I'm there to hold onto her. My question comes down to this: Does anyone have experience with the different types of radiosurgery treatment options? I've noticed that only a dozen of facilities in the U.S have the proton beam device, which makes me think this is a superior type of treatment. Is it more accurate or does it all depend on the size, shape, and location of the AVM? We live in upstate NY, so I'm tempted to give Massachusetts General Hospital a call. I don't want to have the treatment done at a facility that's just convenient for us. I want my wife to get the best treatment available. BTW - my wife is 31 years old. Thanks for reading.