Arteriovenous Malformations

Signs and Symptoms

Arteries carry oxygen-rich blood away from the heart to the body's cells and veins return oxygen-depleted blood to the lungs and heart. When arteriovenous malformations (AVMs) disrupt this process, they can reduce the amount of oxygen received by brain tissues.

Although people are born with AVMs, symptoms typically don't develop until early adulthood, between 20 to 40 years of age. The most common symptoms include:

• Hemorrhage or bleeding into the brain
• Headache
• Stroke
• Other neurological deficits, depending on the AVM location

Diagnosis

The following tests may be used to diagnose your arteriovenous malformation (AVM), as well as help identify its size, location and blood-flow pattern.

Computed Tomography (CT) Scan -- With this test, X-ray beams are used to create a three-dimensional image of the brain. A CT scan typically can detect bleeding into the brain, called a hemorrhage, which indicates an AVM.

Magnetic Resonance Angiography (MRA) -- This procedure is a magnetic resonance imaging (MRI) study of the blood vessels. Using a strong magnetic field, a MRI can generate a three-dimensional image of the brain that can be used to detect, diagnose and aid the treatment of various vascular disorders. A MRA provides detailed images of blood vessels. The procedure is painless and the magnetic field is not known to cause tissue damage of any kind.

Angiography -- This special X-ray exam shows the structure of a person's blood vessels and is essential in the diagnosis and treatment planning of AVMs. During this procedure, a harmless dye that can be seen on X-rays is injected into an artery that supplies blood to the brain. The dye follows the path of the brain's blood flow and can show any obstructions or leaks.

Treatment

Today there are many safe and highly effective therapies available to treat arteriovenous malformations (AVMs). These include surgery, radiation therapy, embolization and radiosurgery using a machine called a Gamma Knife.

• Surgery -- In many cases, surgery may be recommended to completely remove the AVM. In addition to conventional brain surgery, we offer advanced, minimally invasive surgical techniques to treat AVMs.
• Embolization -- Embolization also may be part of your treatment plan. This technique aims to reduce blood flow to the AVM by obstructing surrounding blood vessels. During this procedure, the AVM is filled with specially designed coils, glues or spheres, which plug its vessels. As a result, blood flow is decreased, making the AVM more manageable for future procedures such as surgery.
• Radiosurgery - - The Gamma Knife, an advanced radiosurgery treatment for abnormal blood vessel formations, is often recommended for people with complex, deep seated or brain stem AVMs. Despite its name, it isn't a knife at all. It delivers a single, very finely focused, high dose of radiation precisely to its target, while causing little or no damage to surrounding tissue. The Gamma Knife may be used in combination with other treatments, such as surgery, or by itself as the primary therapy.