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
