Arteriovenous Malformations of the Central Nervous System

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

How to Say It: Ar-teer-ee-o-vee-nus Mal-form-ay-shons

Definition

Arteriovenous malformations (AVMs) are abnormal tangles of blood vessels. They can be found anywhere in the body. AVMs of the brain and spinal cord are the most serious.

Arteriovenous Malformation in the Brain
AVM brain blood vessels

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Causes

The cause is not known.

Risk Factors

Things that may raise the risk are:

  • A family history of AVMs
  • Prior head injury
  • Prior surgery or radiation therapy

Symptoms

Not all people have symptoms. Symptoms may vary in those who do. It depends on the size and location of the AVM. A person may have:

  • Headaches
  • Loss of movement on one side of the body
  • Weakness
  • Sudden, severe back pain
  • Problems with certain movements, such as walking
  • Speaking problems
  • Vision problems
  • Memory loss
  • Confusion or problems thinking
  • Shaking that they cannot control

Diagnosis

You will be asked about your symptoms and health history. A physical exam may be done.

Images may be taken. This can be done with:

AVMs that do not cause symptoms may be found during testing for another health problem.

Treatment

The goal of treatment is to prevent bleeding and to remove the AVM.

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 may be given to manage an AVM that has not ruptured. They may also be given to ease:

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

Surgery

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

  • Microsurgery —An operation to remove the AVM. 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.
  • Radiosurgery —A beam of radiation is focused on the AVM. It destroys the blood vessel walls leading to the AVM. This will block off blood flow to AVM.

Prevention

There is no way to prevent AVMs. The cause is not known.

RESOURCES:

American Stroke Association
http://www.strokeassociation.org

National Institute of Neurological Disorders and Stroke
https://www.ninds.nih.gov

CANADIAN RESOURCES:

Canadian Neurological Sciences Federation
http://www.cnsfederation.org

Heart and Stroke Foundation
http://www.heartandstroke.ca

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. Accessed October 1, 2020.

Intracerebral hemorrhage. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/intracerebral-hemorrhage. Accessed October 1, 2020.

Nussbaum ES. Vascular malformations of the brain. Minn Med. 2013 May;96(5):40-43.

Seizure in adults. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/seizure-in-adults. Accessed October 1, 2020.

Spinal cord arteriovenous malformations (AVMs). Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/neurologic-disorders/spinal-cord-disorders/spinal-cord-arteriovenous-malformations-avms. Accessed October 1, 2020.

Vascular malformations in the brain. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/vascular-malformations-in-the-brain. Accessed October 1, 2020.

What is an arteriovenous malformation (AVM)? American Stroke Association website. Available at: http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/HemorrhagicBleeds/What-Is-an-Arteriovenous-Malformation-AVM_UCM_310099_Article.jsp#. Accessed October 1, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 10/1/2020