Find here some features of the signs and symptoms of Central Nervous System Vascular Malformations
The signs and symptoms may not be evident until 20’s or later. Once they appear, they start deteriorating as the time passes by.
The initial signs include slight difficulty in learning or behavioral disorders in some children or adolescents.
If you do not experience any symptoms of AVMs till 40’s or early 50’s, you are less likely to experience them later even though you carry the condition.
Pregnancy associated cardiovascular changes like increased blood volume and pressure may cause the symptoms to appear suddenly or worsen them.
Vein of Galen is an atypical symptom of severe AVMs in which abnormally connected arteries and veins are found in the deep regions of brain. It causes hydrocephalus (fluid buildup in certain spaces of the brain resulting in enlarged head), inflamed veins on the scalp, seizures, failure to thrive, and congestive heart failure. Children with this condition often have physical and mental disabilities.
The exact cause of vascular malformation of the central nervous system is unknown. Malformation is believed to occur during fetal development.
In few cases, genetic mutation is the probable cause. Some types of vascular malformations are hereditary.
Few studies suggest acquired brain injury can also cause this condition. The formation and growth of blood vessels in fetus are controlled by endogenous chemicals called angiogenic factors.
Abnormal angiogenic factors may cause malformation of blood vessels. But it’s not clear what causes such structural changes in angiogenic factors. Mutation in chromosome 7 is found to cause a type of cavernous malformation with multiple lesion. This genetic mutation is more common in Hispanic Americans living in the Southwest.
Some other hereditary central nervous system vascular defects include
It is wise to evaluate the risk before starting any treatment for AVMs. Untreated AVM can cause hemorrhages that may lead to neurological deficits or death.
So surgery is recommended if the risk of hemorrhage and resultant neurological damage is high. Unfortunately, surgery is complex and can cause serious complications or death.
An AVM grading system can help your doctors assess the risk of surgery based on the size of the AVM, position in the brain and involvement of neighboring tissues, and any leakage. The surgical options for AVMs include
The choice of the option depends largely on the size and location of an AVM. Endovascular embolization and radiosurgery are relatively safer for deep seated AVMs.
For smaller or superficial AVMs, surgery can remove the middle part of the AVM, including the fistula without damaging neighboring neurological structures. This option is not recommended for deep seated AVMs.
A tiny flexible tube (catheter) is inserted into artery and guided to the AVM. As the catheter reaches the area of malformations, fast-drying glue-like substances, fibered titanium coils, and tiny balloon, is released into the area through the tube. This creates an artificial blood clot in middle of AVM which seals off the malformed blood vessel. It is used prior to surgery or radiosurgery to reduce the amount of blood flow through AVM.
It is a noninvasive approach used to treat small unruptured AVMs. A beam of radiation is focused on your AVM to damage the walls of the blood vessels. The blood vessels then slowly degenerate and ultimately close.
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