Arteriovenous Malformations of the Central Nervous System

(AVM; Arteriovenous Malformations of the Brain; Arteriovenous Malformations of the Spinal Cord)

Pronounced: Ar-teer-ee-o-vee-nus Mal-form-ay-shons

Definition

Arteriovenous malformations (AVMs) are tangles of abnormal blood vessels. They can form wherever arteries and veins exist. They can be found anywhere in the body. AVMs of the central nervous system (brain and spinal cord) are the most serious.

Arteriovenous Malformation in the Brain

AVM brain blood vessels
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Causes    TOP

The cause of AVMs is unknown.

Risk Factors    TOP

Your chances of AVMs are higher if:

  • They run in your family—your genes may play a role
  • You had a head injury
  • You had surgery or radiation therapy

Symptoms    TOP

In many cases, AVMs don’t cause problems. In those that have them, symptoms differ between people. They depend on the size and site of the AVM.

AVMs in the brain may cause:

  • Headaches
  • Seizures
  • Loss of movement on one side of the body
  • Weak muscles
  • Problems with certain movements
  • Loss of coordination, mainly when walking
  • Sudden, severe back pain
  • Speaking problems
  • Vision problems
  • Memory loss
  • Confusion or thinking problems

Serious complications of bleeding can lead to:

Diagnosis    TOP

The doctor will ask about your symptoms and health history. AVMs may be found during testing for another reason. You may have:

Treatment    TOP

You may need to see a specialist for care. The goals of care are to remove or damage the AVM, and prevent bleeding.

Care depends on if the AVM has ruptured or not. Sometimes, more than one method is used. Care may be in a hospital.

Medicines

Medicines help ease symptoms. They also manage problems of an AVM that hasn’t ruptured. Medicines treat:

  • Pain
  • Seizures
  • Pressure inside the skull
  • High blood pressure
  • Blood clots

Surgery

If the AVM ruptured, surgery may be delayed for 2-6 weeks. The type depends on the size and site of the AVM. Options include:

  • Microsurgery—An operation to remove the AVM through a hole in the skull. A special microscope will help the surgeon see the area.
  • Embolization—A tube is inserted through the skin. It is passed through arteries until it reaches the AVM. A substance is passed to the area. It will block off blood flow to the AVM. This is a more common option with AVMs found deeper in the brain.
  • Radiosurgery—A beam of radiation is focused on the AVM. It destroys the blood vessel walls leading up to the AVM. This will block off blood flow to AVM. Stereotactic radiosurgery (SRS) delivers radiation to an exact site. It decreases damage to nearby tissue.

Prevention    TOP

There is no way to prevent AVMs since the cause is unknown.

RESOURCES:

American Stroke Association
http://www.strokeassociation.org
National Institute of Neurological Disorders and Stroke
https://www.ninds.nih.gov

CANADIAN RESOURCES:

Heart and Stroke Foundation
http://www.heartandstroke.ca
Canadian Neurological Sciences Federation
http://www.cnsfederation.org

References:

Arteriovenous malformation information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Arteriovenous-Malformation-Information-Page#disorders-r1. Updated June 15, 2018. Accessed July 11, 2018.
Geibprasert S, Pongpech S, Jiarakongmun P, Shroff MM, Armstrong DC, Krings T. Radiologic assessment of brain arteriovenous malformations: what clinicians need to know. Radiographics. 2010;30(2):483-501.
Intracerebral hemorrhage. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated July 11, 2018. Accessed July 11, 2018.
Ogilvy CS, Stieg PE, Awad I, et al. AHA Scientific Statement: Recommendations for the management of intracranial arteriovenous malformations: a statement for healthcare professionals from a special writing group of the Stroke Council, American Stroke Association. Stroke. 2001;32(6):1458-1471.
Seizure in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114746/Seizure-in-adults. Updated December 30, 2016. Accessed July 11, 2018.
Spinal cord arteriovenous malformations (AVMs). Merck Manual Professional Version website. Available at:
...(Click grey area to select URL)
Updated October, 2016. Accessed July 11, 2018.
Vascular malformations of the brain. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated June 6, 2018. Accessed July 11, 2018.
What is an arteriovenous malformation (AVM)? American Stroke Association website. Available at:
...(Click grey area to select URL)
Updated June 22, 2017. Accessed July 11, 2018.
Last reviewed June 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 7/11/2018

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