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Arteriovenous Malformations (AVM)

Arteriovenous malformations (AVMs) occur when arteries and veins connect abnormally. This disturbs blood flow and circulation of oxygen.

Arteriovenous Malformations (AVMs)

             Arteriovenous malformations (AVMs) occur when arteries and veins connect abnormally. This disturbs blood flow and circulation of oxygen. Arteries function in delivering oxygen to the brain and heart, while veins supply the oxygen to the lungs and heart. Therefore, when the condition happens,  it may cause the surrounding tissues to lack oxygen , especially lungs, heart and brain. The depletion of oxygen may result in hemorrhage or bleeding in brain, stroke or brain damage. Arteriovenous malformations can occur anywhere in the body but commonly found in the brain or spine. Even though the cause of this condition is still unknown, complications of brain AVMs can be prevented and reduced successfully by some treatment.

 

Symptoms

            Arteriovenous malformationsSigns and symptoms of AVMs differ to the location they exist. The symptoms that can be experienced after bleeding may include:

    • Bleeding
    • Headaches
    • Nausea and vomiting
    • Seizures
    • Loss of consciousness
    • Progressive loss of neurological function

 

            People with AVMs may also have:

    • Dizziness
    • Weak muscles
    • Weakness in the lower extremities
    • Back pain
    • Vision problem such as uncontrollable eye movement or swelling of optic nerve
    • Numbness, tingling or sudden pain
    • Confusion
    • Loss of memory
    • Aphasia or problem with speech or the understanding of language
    • Apraxia or problems of performing task
    • Hallucination
    • Problem with learning or behavior in children or teen patients

 

            AVMs that occur shortly after birth are called a vein of Galen defect. This type of AVMs locates deep inside the brain anc may cause:

    • Hydrocephalus or increase of fluid in the brain that causes head enlargement
    • Swollen veins on the scalp
    • Seizures
    • Failure to thrive
    • Congestive heart failure

 

When to see the doctor

             Should not avoid any of your headaches, dizziness, vision problems or changes in cognition or neurological function. You are advised to consult a doctor if any of these symptoms appear. 

 

Risk factors

            It is found that there might be a relationship between hereditary and AVMs. The risk of AVMs tends to be increased in people whose family members have been involved with this disease.

 

Complications

             Bleeding is the most common complication of AVMs. It can lead to serious neurological damage if left untreated.

 

Diagnosis

            The doctor may start the diagnosis with hearing the sound of blood flow through arteries and veins called bruit. You may be checked with several tests which may include:

 
  • Cerebral angiography
To investigate the structure of blood vessels
  • CT scan
To seek for bleeding of blood vessels in head, brain or spinal cord
  • MRI
To show the detailed image of the tissues
  • MRA
To monitor the speed, pattern and distance of blood flow through the vascular abnormalities
  • Transcranial Doppler ultrasound
To categorize large and medium AVMs and to investigate for the bleeding

 

Treatment

             The treatment for AVMs differs in its bleeding, size and location. The treatment may include the use of medications, surgery and follow-up.

 

  • Medications

             The aim of using medications is to manage the symptoms of AVMs including seizures, headaches and back pain.

 

  • Surgery

             The doctor may recommend a surgery for patients with high risk of bleeding. The surgery might include completely removing the AVMs. However, the procedure might cause damage to brain tissues. Other kinds of surgery may include: endovascular embolization and stereotactic radiosurgery.

 

  • Follow-up

             To maintain healthy life and prevent the recurrence of the disease, the patients are required to have regular follow-up with the doctor. The doctor may conduct several image test to monitor the AVMs.

 

Preparing for the appointment

Before your appointment, you may:

  • note down your experiencing symptoms
  • list your current medications
  • beware of restrictions prior the appointment
  • prepare the questions that you want to ask the doctor

 

During the consulting, the doctor may ask some questions including the information such as:

  • the beginning of your symptoms
  • whether the symptoms are continuous or occasional
  • the severity of the symptoms
  • whether there is anything improve or worsen the symptoms