Treating Arteriovenous Malformation (avm) of the Brain

Characterized by headaches and seizures, an arteriovenous malformation (AVM) of the brain is a derivative of arteriovenous malformation, a disorder of the body’s circulatory system. An AVM of the brain, also known as a cerebral AVM, is a malformed group of blood vessels composed of an intricate tangle of arteries and veins. Though localized, cerebral AVMs can lead to severe neurological problems. Research in the field of arteriovenous malformation is growing particularly with noninvasive treatment options.




What are cerebral AVMs?




Cerebral AVMs may form during prenatal stages of a child’s development, either during embryonic or fetal growth. Studies have found a certain number of cases form shortly after birth; however, the condition frequently presents in adults in their 20s or 30s. Cerebral AVMs are commonly misdiagnosed, with most cases found only incidentally through the performance of CT (computed tomography) scans on the brain. Patients complain of regular headaches and seizures before diagnosis.




Other neurological complications can develop including speech and visual difficulty, dizziness, memory deficits, confusion, hallucinations, dementia and difficulty with event planning. Physical side effects range from loss of coordination, numbness, tingling and spontaneous pain to permanent paralysis. Patients’ symptoms are directly associated with the location of the cerebral AVM with certain sites causing hydrocephalus. Hydrocephalus is caused by a cerebral AVM preventing the circulation of cerebrospinal fluid thereby causing fluid build-up in the skull.




What are the potential health consequences of cerebral AVMs?




Hemorrhaging is the most common side effect of patients experiencing cerebral AVM. The size and location of the cerebral AVM determines the patient’s likelihood of experiencing hemorrhaging. Research has found between 2 and 4 percent of all AVMs to hemorrhage each year with most episodes going undetected. Minor hemorrhaging does not cause neurological damage, hence the reason patients and doctors remain unaware it takes place. On the other hand, massive hemorrhaging has been documented with some cases being fatal. Once a cerebral AVM bleeds, the risk of hemmorahaging again within the next year is nine times as likely. Though research has grown extensively, doctors are still unable to predict whether a patient with cerebral AVM will or will not experience hemorrhaging.




While there is no definitive research, doctors have found certain cases to have a higher likelihood of causing bleeding. Though it may seem contradictory, smaller AVMs have a greater chance of hemorrhaging than larger ones. Increased blood pressure and blood volume from being pregnant also increases a patient’s potential for bleeding. Lastly, deeply situated AVMs with extremely narrow veins impair proper drainage leading to an increased risk for hemorrhaging.




Once again, the location of the hemorrhaging AVM is directly proportionate to the side effects of hemorrhaging. Bleeding AVMs situated deep within the brain, called intracerebral or parenchymal cerebral hemorrhage, cause the most damage.




In addition to brain hemorrhaging, AVMs on their own can inflict harsh brain and spinal dysfunctions. Patients who experience severe side effects are typically victims of one of three problems. Aside from hemorrhaging, AVMs reduce oxygen reaching neurological tissues and compress and displace parts of the brain. The larger the lesion, the greater chance of the latter problem occurring with certain AVMs reaching up to 2.5 inches in diameter. Certain lesions have been documented to distort an entire hemisphere of the brain.