Brain arteriovenous malformation (AVM) is a health condition that comes into existence when blood vessels interlinked to veins and arteries inside the brain region of an individual gets twisted in an abnormal manner. Continuous flow of oxygenated blood to brain is important for its proper functioning. Presence of AVM in brain may adversely affect this crucial process and lead to disabling conditions such as stroke. Therefore, patients suffering from AVM should reach out for a prompt medical help. It will definitely help them in maintaining a good quality of life.
Types of Brain Arteriovenous Malformation
The following points elaborate some of the major types of brain arteriovenous malformations (AVM).
- True Arteriovenous Malformation – This is the most commonly observed type of brain It occurs when abnormal blood supplying vessels gets intertwined with veins and arteries directly without any brain tissue.
- Cryptic or Cavernous Malformation – Cryptic brain AVM is a vascular defect in brain that tends to get ruptured easily causing severe bleeding. They may also lead to seizures if not treated timely.
- Venous Malformation – Venous brain AVM is a condition that affects only the veins present in the brain area. Veins may become enlarged over a period and result in serious problems.
- Hemangiomas – Hemangiomas represent altogether different type of AVM that is generally located on facial structures or skin area. They may start to accumulate on base area of brain and swell considerably if proper care is not taken at the earliest.
- Dural Fistula – Outer covering of brain area is clinically referred to as ‘dura mater’. Abnormal interconnection of blood vessels that appear on the covering of brain is called as ‘dural fistula’. Such type of AVM can be identified by symptoms such as headaches, ear problems, and poor vision.
Causes and Risk Factors for Brain Arteriovenous Malformation
There are no known causes for occurrence of brain arteriovenous malformation (AVM). However, healthcare professionals believe that such type of abnormalities may result from abnormal fetal development. Apart from that, the given risk factors may also increase the likelihood of development of brain arteriovenous malformation.
- Gender – It has been observed that males are more prone to getting brain arteriovenous malformation as compared to women.
- Genetic Problems – People suffering from several genetic conditions such as Osler-Weber-Rendu syndrome or hereditary hemorrhagic telangiectasia are at greater risk of developing brain
Signs and Symptoms of Brain Arteriovenous Malformation
Brain AVM may not necessarily cause prominent symptoms until it gets enlarged or ruptured. However, in some cases, patients may have to face the following signs and symptoms.
- Seizures and Headaches – Most of the patients struggling with an underlying brain AVM are likely to experience seizures. They may also encounter frequent headaches due to enlargement of
- Muscle Weakness or Paralysis – Muscle weakness and numbness specifically on one side of the body may occur due to an unrecognized AVM in brain.
- Poor Eyesight – In some instances, brain arteriovenous malformation may create pressure on nerves that are interconnected to eyes of patients and result in poor eyesight.
- Confusion and Unsteadiness – Patients suffering from condition of brain arteriovenous malformation may experience unsteadiness and confusion in everyday tasks. Such problems may start to interfere and affect their overall life.
- Speaking Difficulties – Patients may have to face speaking difficulties due to presence of brain arteriovenous malformation (AVM).
Diagnosing Brain Arteriovenous Malformation
Patients who are experiencing unusual signs and symptoms of brain AVM should consult experienced neurosurgeons who have expertise in handling such cases. It will definitely raise the chances of successful outcomes following their brain arteriovenous malformation treatment.
- Medical Status Evaluation – During healthcare consultation, respective neurosurgeons may ask patients for their complete medical history report. After analyzing their medical history, they may request them to reveal regarding the symptoms that are bothering them. After that, they may order the following tests in order to confirm the presence of brain
- Cerebral Angiography Test – Also called as ‘cerebral arteriography’, cerebral angiography is one of the most effective diagnostic tests for brain arteriovenous malformation. During cerebral angiography test, patients will be sedated using local anesthesia. Respective neurosurgeons use a specialized medical instrument known as ‘catheter’ and insert it into patient’s groin by making a small incision. Catheter is equipped with a camera that can easily guide doctors to reach the brain area smoothly. Doctors will closely monitor their underlying problem with the help of pictures obtained by using such catheter-based imaging technique. They may also inject a medical dye-like substance through catheter for obtaining better results.
- Computerized Tomography (CT Scan) – Computerized tomography procedure is quite a widely used painless imaging method. During CT scan, respective doctors ask patients to lie in a comfortable manner inside a device that emits x-rays. These x-rays are capable of creating precise images of patient’s entire brain as well as surrounding areas. Doctors thoroughly inspect the obtained images to figure out size, position, and current status of brain
- Magnetic Resonance Imaging (MRI) – Magnetic resonance imaging is similar to procedure of CT scan. However, during MRI scanning, radio frequency waves and magnetic fields are utilized instead of x-rays. Patients are exposed to a device that emits radio frequency waves in combination with magnetic fields. Doctors believe that MRI gives more clear images with complete details. Nowadays, MRI scan is preferred over CT scan due to its high degree of accuracy.
Treatment Options for Brain Arteriovenous Malformation
Initially, respective neurosurgeons may prescribe medications to help patients manage the symptoms of brain arteriovenous malformation. Medical monitoring along with medicines may help if AVM is extremely small and does not cause any significant problem. However, if it has become enlarged or on a verge of getting ruptured, doctors may recommend surgery and other advanced treatments to patients. The following list depicts the three major types of treatments that can be used for brain arteriovenous malformation.
- Surgical Resection of Arteriovenous Malformation – Surgical resection of arteriovenous malformation is possible if AVM is present in a location that can be operated without causing damage to healthy tissues in brain. This surgery is performed under general anesthesia in order to decrease the risks of pain and discomfort. Patients will be asleep until the surgery gets completed. Respective neurosurgeons carefully make an incision and remove a small portion of skull temporarily to reach to underlying arteriovenous malformation. They use a high powered microscope and sophisticated clips to resect the AVM. They reattach the skull portion once everything is done and close the incision. This step marks the successful completion of arteriovenous malformation resection surgery. Doctors may monitor them for a couple of hours in order to keep a check on their health.
- Endovascular Embolization of Arteriovenous Malformation – Working principle of endovascular embolization of arteriovenous malformation procedure is to cut off the supply of blood from an artery to stop AVM from growing and minimize its symptoms. It can be performed either under local anesthetics or general anesthetic medicines. During endovascular embolization of arteriovenous malformation procedure, respective neurosurgeon will insert a catheter into patient’s groin and guide it towards the artery where AVM is situated. After that, doctors will insert an embolizing glue-like substance that will block the flow of blood in that particular area. Doctors may perform this medical procedure along with other treatments like surgical resection once the size of AVM gets shrinked.
- Stereotactic Radiosurgery for Arteriovenous Malformation – Stereotactic radiosurgery for arteriovenous malformation (SRS) is an advanced treatment that uses sharp and focused beams of radiation in order to destroy the tangled blood vessels that contribute to AVM Doctors will use a three-dimensional imaging (3D) system that will help in determining the location and size of AVM. After that, patients will be exposed to a huge medical device that will emit precise radiation at targeted areas. Respective doctors use this treatment when surgery may cause severe complications like hemorrhage in patient’s brain.
Risks and Complications Associated with Treatments of Brain Arteriovenous Malformation
The given list describes some of the risks and complications associated with different treatments of brain arteriovenous malformation.
- Surgical Resection of Arteriovenous Malformation – Surgical resection of arteriovenous malformation may result in complications such as bleeding in brain, infection at incision site, clotting of blood, and intense pain and swelling around brain.
- Endovascular Embolization of Arteriovenous Malformation – Patients who have undergone endovascular embolization of arteriovenous malformation may have to face problems like severe infection, damage to artery, stroke, and bleeding in brain area.
- Stereotactic Radiosurgery for Arteriovenous Malformation – Stereotactic radiosurgery for arteriovenous malformation may lead to complications like fatigue, swollen and red skin, and hair loss.
Recovery Following Brain Arteriovenous Malformation Treatment
Recovery is mainly dependent on factors such as particular type of brain arteriovenous malformation treatment which is implemented by respective neurosurgeon, severity of patient’s condition, and care during postoperative period. Patients who follow doctor’s instructions carefully are likely to recover faster as compared to others. It is quite natural for patients to feel depressed due to such unfortunate event. They may try talking to near ones or clinical psychologists in order to cope with the uncertainty and emotions. Patients should eat healthy and indulge in mind rejuvenation activities such as deep breathing. It will not just improve their state of physical being but mental being as well. Most importantly, patients should keep visiting respective doctors for follow-up care sessions for minimizing the possibility of complications in long run.
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