ARTERIOVENOUS MALFORMATIONS

TYPES

The aberrant blood vessel tangles known as arteriovenous malformations (AVMs) join arteries and veins without using the capillary system. Although they may affect any region of the body, the brain and spinal cord are the most often affected. A few examples of arteriovenous malformations are as follows:

• Brain AVMs: These are abnormal tangles of blood vessels in the brain. Brain AVMs can vary in size and complexity and may cause symptoms such as headaches, seizures, neurological deficits, or hemorrhages if they rupture.
• Spinal AVMs: These develop in the spinal cord’s blood vessels. Back discomfort, numbness or paralysis in the limbs, trouble walking, and bowel and bladder problems are just a few of the symptoms that may result from spinal AVMs.
• Pulmonary AVMs: These aberrant arteries and veins in the lungs linkages. Due to blood circumventing the normal lung capillary system, pulmonary AVMs may result in issues including breathing difficulties, low oxygen levels, or an increased risk of infection.
• Hepatic AVMs: These are arteriovenous malformations that occur in the liver. Hepatic AVMs can cause symptoms such as abdominal pain, liver enlargement, jaundice, or high-output heart failure due to abnormal blood flow patterns.
• Facial AVMs: These are AVMs that affect the blood vessels in the face. Facial AVMs can cause cosmetic changes, such as a swollen or discolored appearance, as well as functional problems like difficulty eating, speaking, or breathing.

SYMPTOMS

Symptoms of Arteriovenous malformations include:

• Headaches: A frequent symptom of AVMs is persistent or recurrent headaches. These headaches can range in intensity and may be accompanied by other symptoms such as dizziness or nausea.
• Seizures: AVM sufferers are much more likely to develop seizures. Convulsions, loss of consciousness, or strange motions are all signs of seizures.
• Neurological deficits: AVMs located in certain areas of the brain or spinal cord can cause neurological deficits. These deficits may include weakness or numbness in specific body parts, difficulty with coordination or balance, or problems with speech or vision.
• Bleeding: One of the most significant risks of AVMs is bleeding. If an AVM ruptures or leaks, it can lead to bleeding in the brain or spinal cord, resulting in sudden and severe neurological problems. Symptoms of bleeding may include a sudden and severe headache, weakness or paralysis, difficulty speaking or understanding speech, changes in vision, or loss of consciousness.
• Other symptoms: Depending on the location of the AVM, additional symptoms may occur. For example, if the AVM is in the gastrointestinal tract, it may cause gastrointestinal bleeding or abdominal pain. AVMs in other areas of the body can result in symptoms specific to that area.

DIAGNOSIS

Arteriovenous malformations (AVMs) are normally diagnosed using a combination of physical examination, imaging testing, and medical history analysis. Here is a summary of the AVM diagnosis procedure:

1. The healthcare provider will start by reviewing your symptoms, medical history, and any risk factors before doing a physical examination. They will also do a physical examination to check for any neurological problems or other AVM-related symptoms.
2. Imaging testing: Magnetic resonance imaging (MRI) and angiography are the main imaging techniques used to identify AVMs.
3. Magnetic resonance imaging (MRI): An MRI scan produces precise pictures of the brain or spinal cord using strong magnets and radio waves. It offers details on the AVM’s size, location, and features while aiding in the visualization of the blood vessels.
4. Angiography: An X-ray is taken after a contrast dye is injected into the blood arteries during an angiogram. This examination helps pinpoint the AVM’s specific location and connections while giving a clear picture of the blood flow inside of it.
5. More testing: In certain circumstances, more tests may be necessary to learn more about the AVM and its effects on the tissues nearby. Functional tests to assess certain neurological functions or computed tomography (CT) scans may be part of these examinations.

TREATMENT

1. Observation: In certain cases where the AVM is small, asymptomatic, and located in a relatively low-risk area, a healthcare professional may recommend a “watch and wait” approach.
2. Medications: Medications may be prescribed to manage specific symptoms associated with AVMs, such as pain, seizures, or headaches. These medications can help control symptoms, but they do not treat the AVM itself.
3. Embolization: In this procedure, a catheter is inserted into the blood vessels and guided towards the AVM. Embolic materials, such as glue or small particles, are then injected to block or reduce the blood flow to the AVM. This treatment can help reduce the risk of bleeding and relieve symptoms.
4. Radiosurgery: Radiosurgery, such as stereotactic radiosurgery, uses focused beams of radiation to target and treat the AVM. This treatment aims to cause changes in the blood vessels of the AVM over time, leading to its closure. It is a non-invasive approach that can be effective for smaller AVMs or those in inaccessible locations.
5. Surgery: Surgical removal of the AVM may be considered for certain cases, especially if the AVM is causing severe symptoms, is at high risk of bleeding, or is in a surgically accessible location. This procedure involves removing the AVM and repairing the affected blood vessels.