Arteriovenous Malformation

1 What is Arteriovenous Malformation?

Arteriovenous malformation (AVM) is an abnormal connection of blood vessels in which the arteries and veins form a tangle, affecting the flow of blood. 

It is a congenital condition and is most commonly found in the brain and spinal cord. The diminished blood flow may affect many tissues and organs, or cause the blood vessels to weaken and rupture. 

Malformation of blood vessel in brain may lead to rupture of veins and arteries in brain leading to hemorrhage and stroke

The actual cause of AVM is not clear. AVM can be treated successfully and complications reduced.

2 Symptoms

Symptoms of Arteriovenous malformation depends on the location, size, risk factor, and the type of blood vessel affected by the malformation. 

Symptoms vary from mild to severe. Some common symptoms of AVM includes:

  • Weakness of muscles or paralysis
  • Lack of coordination that leads to differences in gait
  • Difficulty in planning
  • Back pain or weakness
  • Dizziness
  • Inability to control eye movements
  • Difficulty in understanding language
  • Memory problems
  • Confusions, hallucinations, and dementia
  • Numbness, tingling, or pain

Most common symptoms of AVM are seizures and headaches, and both symptoms are generalized. 

3 Causes

The actual cause of Arteriovenous malformation is not known. It is believed that the condition occurs in the womb or shortly after delivery. Symptoms appear later as the child ages. 

AVMs of brain and spinal cord are present at the time of birth. AVMs are not found to run in families.

4 Making a Diagnosis

A combination of MRI and angiography is used in the diagnosis of Arteriovenous malformation. Review of symptoms, medical history, and family history of the patient provide important clues regarding the condition. 

MRI provides a detailed visual of the soft tissues in the brain. Magnetic resonance angiogram (MRA), a modified version of MRI, in which a contrast dye is injected through the blood vessels helps to illuminate the blood vessels. 

In an angiogram, a catheter is inserted into the blood vessel and guided to the brain. Once the catheter is in place, a contrast dye is injected before taking X-ray images of the blood vessels.

5 Treatment

Surgery and focused radiation therapy are the definitive treatment options for Arteriovenous malformation. General symptoms of AVM can be managed by using medications.

There are three surgical methods for treating the malformation namely:

Conventional surgery – this procedure involves removal of the malformation causing as little damage as possible to the surrounding tissues. It is most commonly recommended when the AVM is relatively small and is present superficially in the brain and spinal cord. 

Endovascular embolization – is a procedure in which a catheter is introduced into the arterial network and guided to the site of AVM. A substance like fast-drying glue or fibered titanium coil is injected which forms a clot in the center of AVM. 

Embolization is usually used along with surgery or radiosurgery, as the procedure will not completely obliterate an AVM. 

Radiosurgery – a beam of highly focused radiation is directed on the AVM to damage the wall of the blood vessels that make up the malformation. The irradiated blood vessels gradually degenerate and close over a period of time. 

Staged embolization followed by conventional surgery or radiosurgery is now used to permanently obliterate the lesions and to reduce the complication rates. 

6 Prevention

As the actual cause of the condition is not known, it is not possible to prevent Arteriovenous malformation. 

Controlling the symptoms and treating the conditions as early as possible helps to prevent complications.

7 Alternative and Homeopathic Remedies

Examples of alternative and homeopathic remedies used to alleviate symptoms of Arteriovenous Malformation are chinese herbal medicine and acupuncture.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with Arteriovenous malformation.

Managing hypertension, avoiding blood-thinning medications, and being regular with checkups are very important to monitor the condition and to prevent complications.

9 Risks and Complications

Arteriovenous malformations in brain may result in complications like brain hemorrhage and reduced oxygen supply to the brain tissue. 

Blood vessels may be weakened and thin, and it may also lead to brain damage.

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