About Arteriovenous Malformations (AVMs)
An arteriovenous malformation (AVM) is an abnormal collection or tangle of blood vessels. It causes blood to rapidly flow from your arteries to your veins, bypassing your interconnecting capillaries.
An AVM may have developed in your brain, spinal cord or another part of your body. It may have been caused by a problem with blood vessel formation during early development in the womb, or in some cases may be associated with an inherited condition.
Symptoms of an Arteriovenous Malformation (AVM)
The symptoms you have may be different from those of someone else with an AVM. This is because symptoms vary greatly in nature and severity, depending on the location and size of the AVM and the type of blood vessels involved. Common symptoms include:
- Seizures
- Headache
- Weakness or paralysis on one side of the body
- Numbness and tingling
- Problems with vision, balance, hearing and memory
Some AVMs do not produce any symptoms at all.
Diagnosing an Arteriovenous Malformation (AVM)
Your doctor may have ordered one or more of the following imaging tests to confirm your AVM:
- Catheter angiography: A procedure that uses a dye and X-rays to produce images of the blood vessels in your brain and spinal cord. The dye is injected directly into your artery through a small tube (typically inserted in your groin.) It highlights your blood vessels, resulting in the best images doctors can currently obtain for AVMs. This test, unlike others, generates a moving image of your blood flow and is needed to confirm the presence of an AVM. This test also allows a doctor to determine the exact layout of the tangled blood vessel, and can evaluate for the presence of other blood vessel issues, such as aneurysms or the narrowing of blood vessels.
- Computed axial tomography (CT): A scan that uses X-rays to create images of your brain and spinal cord. Computed axial tomography angiography/angiogram (CTA) is a type of special CT scan that uses a contrast dye injected through a needle in your arm to show up blood vessels more clearly.
- Magnetic resonance imaging (MRI): A scan that uses radio waves and a magnetic field to produce images of your brain and spinal cord. For treatment planning, you will typically get a MRI because it is important to see the AVM in relationship to the brain tissue itself. Magnetic resonance angiography (MRA) is a type of MRI scan that can be done without or with a contrast agent to show up blood vessels in your brain. It is typically less accurate than a catheter angiography or a CT angiography/angiogram.
- Transcranial Doppler ultrasound: A test that uses a probe to direct high-frequency sound waves through your skull. The sound waves that bounce back are interpreted by a computer to create an image that can be used to examine the speed of blood flow through your brain. Nowadays, this test is used less frequently in the diagnosis of AVMs because of the availability of other tests.
Treatment Options for an Arteriovenous Malformation (AVM)
Treatment options for an AVM include:
- Embolization: This surgical procedure is often used to treat AVMs of the brain and reduce the size of large AVMs before surgery. It involves inserting a small tube called a catheter into your groin and guiding it up to the AVM, where an injection of liquid glue, or the insertion of a small metal coil or piece of braided cylindrical mesh, closes up the abnormal connection.
- Microsurgical resection: This surgical procedure is best for treating AVMs of the brain. It involves entering your skull to remove the AVM.
- Stereotactic radiosurgery: This non-surgical, minimally invasive procedure is best for treating smaller AVMs. It involves focusing beams of radiation directly on the AVM to minimize the effect on the surrounding healthy tissues. The radiation damages the blood vessels leading to the AVM, and the AVM occludes itself over months and years to come. After a one time dose of gamma radiation is applied, it typically takes three for the AVM in the brain to disappear.
Treatment for an AVM is very individual, and you will need to work with your doctor or surgeon to find the treatment that is right for you. Factors that can influence treatment decisions include your overall health, your age, the severity of your symptoms and the size and location of the AVM.
Why Choose Neurosurgeons of New Jersey?
Our dedicated team of neurosurgeons adopt a multi-disciplinary approach to treatment and are able to offer a range of cutting-edge treatment options.
Neurosurgeons of New Jersey provides world-class, patient-centered care for neurological conditions. Our state-of-the-art practice has been growing for over two decades and today we are the largest sub-specialized practice in the tri-state area.