Arteriovenous malformation (cerebral)
Alternative names:
AVM
Treatment:
Because symptoms do not usually appear until serious complications such as bleeding occur, arteriovenous malformation is often an emergency condition requiring immediate hospitalization and treatment.
The goal of treatment is prevention of further complications.
Surgical treatment is indicated for AVM. Very large AVM may allow enough short-circuit blood flow to cause cardiac decompensation (where the heart is unable to pump enough blood to compensate for bleeding in the brain). This condition is usually identified in infants and young children.
Diagnosis of a cerebral AVM may be made prior to a catastrophic hemorrhage because of recurrent headaches caused by a tiny amount of bleeding. Early diagnosis is preferable to diagnosis following a catastrophic hemorrhage into the intracranial space. Surgical intervention is dependent upon accessibility of the lesion and status of the patient at the time of surgery. Other indications include increased intracranial pressure (pressure within the brain), and to prevent worsening of loss of brain functions (neurologic deficits). Surgical treatment usually consists of removing, clipping or otherwise destroying the malformation.
Embolization (occlusion of the blood vessel by injecting a substance into the vessel that acts like a clot to stop blood flow) may be an alternative if surgery is not feasible because of size, location, or other factors. Proton beam radiation may be another alternative treatment for inoperable arteriovenous malformation.
Anticonvulsant medications such as phenytoin may be prescribed if seizures occur.
Expectations (prognosis):
The expected outcome varies. Approximately 10% of cases are fatal, usually as a result of bleeding in the brain. Seizures and neurologic changes may be permanent or may resolve with treatment.
Complications:
+ - muscle weakness
+ - numbness of any part of the body
+ - vision changes
Calling your health care provider:
Go to the emergency room or call the local emergency number (such as 911) if severe headache with vomiting, seizures, muscle weakness, numbness of parts of the body, or other symptoms of arteriovenous malformation occur.
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