A cerebral arterio-venous malformation is an abnormal connection between the arteries and veins in the brain that usually forms before birth.
Characteristicsthat might occur with an AVM that has not bled include:
• Decreased sensation in any area of the body
• In an area (localized) or general
• Looks like a migraine headache in a few cases
• Muscle weakness, any area of the body
• Generalized tonic-clonic seizure
• Partial (focal) seizure
• Vision changes
• Blurred vision
• Decreased vision
• Double vision
• Decreased consciousness
• Dysfunctional movement
• Ear noise/buzzing
• Eyelid drooping
• Facial paralysis
• Impaired smell
• Speech impairment
There are frequently no signs until the AVM ruptures. This leads to bleeding in the brain (hemorrhagic stroke). In more than half of patients with AVM, hemorrhage is the first symptom. Characteristics of AVM hemorrhage are thecomparable to those of other intracerebral hemorrhage.
A bleeding AVM is a medical emergency. The purpose oftherapy is further complications by controlling bleeding and seizures and, if it is possible, taking out the AVM.
• Open brain surgical procedure
• Endovascular therapy
Some therapy options are employed together.
Open brain surgical operation removes the malformation through an openingmade in the skull. It must be performed byan extremely skilled neurosurgeon.
Embolization (endovascular therapy) is the injection of a glue-like substance into the abnormal vessels to obstructblood flow in the AVM and reduce the chance of bleeding. This might be the first alternativefor quite a fewforms ofAVMs, or if surgical operation cannot be done.
Stereotactic radiosurgery is another alternative. This procedure delivers radiation straight to the area of the AVM to cause scarring and shrinkinge. It can control bleeding and other characteristics. It is particularly helpful for small deep AVMs, which are challenging to remove by surgical operation.
Anti-convulsant drugs, like phenytoin, are commonly prescribed if seizures occur.
The reason for cerebral arteriovenous malformation (AVM) is unknown. The problem occurs when arteries in the brain connect straight to nearby veins without having the usual vessels (capillaries) between them.
Arteriovenous malformations vary in size and location in the brain.
An AVM rupture occurs as a result of pressure and injury to brain tissue, in addition toan absence of to the brain.Characteristicsmight possibly occur when large AVMs that haven't bled press on the brain tissue.
Cerebral arteriovenous malformations occur in under than 1% of people. Although the problem is present at birth,characteristics may occur at any age. Hemorrhages occur most often in people ages 15 - 20, but can also occurlater. Some patients with an AVM also have cerebral aneurysms.
Tests & diagnosis
An entire physical examination and neurologic examination are needed, but they might be completely normal.
Tests that might be employed to diagnose an AVM include:
• Cerebral angiogram
• Cranial MRI
• Electroencephalogram (EEG)
• Head CT scan
• Magnetic resonance angiography (MRA)
Approximately 10% of cases in which hemorrhage is the first symptom are life threatening. Some patients may havelasting seizures and neurological problems.
• Focal weakness
• Intracerebral hemorrhage
• Language difficulties
• Numbness of any area of the face or body
• Lasting neurologic changes like paralysis or sensory problems
• Persistent headache
• Subarachnoid hemorrhage
• Vision changes
• Water on the brain (hydrocephalus)
Potential complications of open brain surgical operation include:
• Brain swelling
When to get in touch witha doctor
Go to the emergency room or call the local emergency number ( like 911) if you have:
• Numbness in areas of the body
• Severe headache
• Other characteristics of a ruptured arteriovenous malformation
Also seek medical assistance if you have an initial ever seizure, because AVM is often times the reason for seizures.