Arterio Venous Malformations

Arteriovenous malformation or AVM is an abnormal connection between arteries and veins that are usually congenital. An AVM can develop at any part of your body. But it mostly occurs in the brain or spine.

Arterio venous malformations are usually congenital but not hereditary. A brain AVM is an abnormal twist between arteries and veins. Brain AVMs happens very rarely. Brain AVMs can occur anywhere in your or on meninges, its covering. AVMs are more common in males than female.

SIGNS AND SYMPTOMS

Most often the Arterio venous malformations are asymptomatic. It may not show any signs or symptoms until it ruptures or a haemorrhage occurs in the brain. It can be detected on a brain scan or on any other physical test, may be unrelated.

Symptoms of AVMs may vary based on the location of malformation or it may be individual.

Common signs and symptoms of a brain AVM include:

  • Sudden, severe headache
  • Trouble in speakingArterio-Venous-Malformations
  • Loss of vision
  • Difficulty to control yourself or Seizure.
  • Muscle weakness
  • Numbness or paralysis.
  • Confusion and hallucinations.
  • Continuous pain
  • Dizziness

Seek immediate medical attention if you notice any signs or symptoms of a brain AVM. A bleeding brain AVM is very dangerous and requires emergency medical attention.

CAUSES

Arteries and veins are parts of circulatory system. In a normal functioning human body, arteries carry oxygenated blood from the heart to various parts of the body, and veins return the blood to heart for purification. Capillaries are the extremely smallest of the blood vessels and stand as the connection between the arterial and venal systems of the circulatory system. Here in AVMs, there are no capillaries. Instead of a normal structure, an AVM appears as a tangle between arteries and veins. This interferes in the process of blood circulation in the brain.

An AVM can rupture because of pressure and damage to blood vessel tissue and it leads to bleeding in the brain. AVMs can cause intense pain and lead to serious medical problems.

Possible complications of a brain AVM include:

  • Brain damage
  • Persistent headache
  • Bleeding in the brain (Intracerebral hemorrhage)
  • Reduced blood flow to the brain
  • Weakness or numbness in the limbs.
  • Seizures
  • Inadequate Oxygen availability to brain tissues

Important diagnostic tests for AVMs are following:

  • Cerebral angiography– It is the best way to diagnose AVMs or to identify problems with blood vessels in the brain. This diagnostic test is also known as cerebral arteriography. This produces a detailed and clear image of AVMs.
  • Computerized tomography (CT). A computerized tomography (CT) scan takes pictures of the brain using X-rays.
  • Magnetic resonance imaging (MRI) – It uses a large magnet and radio waves to create images of brain. It can give details about the exact location of the malformation. Such details are necessary in deciding treatment options.

TREATMENTS AND DRUGS

CONSERVATIVE MANAGEMENT:

This means managing a person’s symptoms with anti-seizure medications. This may be recommended for very old patients with unruptured AVMs, or very large AVMs that present high risks if treated any other way.

SURGICAL REMOVAL:

Neurologists usually remove small AVMs surgically. At the same time, AVMs which are in deep region of brain may not be treated by this method.

Apart from these, patient’s age and general health will also be considered for surgery. To remove the artery that feed an AVM, surgeon will remove a section of skull to get access to that and will remove that AVM from the neighbouring tissues carefully.

Embolization

Endovascular embolization is usually performed in case of treating relatively larger AVMs. This process is normally performed to block the abnormal arteries by injecting a glue-like material into it. This technique may help to shrink an AVM. If shrinking of AVMs can become possible by this way, other options may not have performed.

Stereotactic Radiosurgery

In this procedure, a high dose, precisely focussed radiation is delivered to AVM to destroy this. This causes blood vessels in AVMs to clot off over a period of time of months or a year after treatment. Small sized AVMs can be treated effectively by this method.