Arterio - Venous Malformation (AVM)

The diseases we call AVM develop because of direct connections between arteries (arteries) and veins ( veins ) without capillaries . It is also called vascular ball because it resembles a ball in appearance . AVMs are generally thought to be congenital and can grow throughout a person's life. As with aneurysms, the most feared situation in AVMs is bleeding. In AVMs , cerebral hemorrhage can occur into the brain tissue, but more often in the surrounding cerebrospinal fluid-filled space, that is, into the subarachnoid space. Aneurysm can also be seen with AVM. This condition is often life threatening. Patients diagnosed with AVM should apply to a neurosurgeon and have the necessary treatment and follow-up.

Symptoms

1. Headache: very severe headaches can be observed, especially in patients with bleeding
2. Seizures: especially young adults may present with new-onset seizures.
3. Depending on the location of AVMs , different types of paralysis, weakness in the arms and legs, speech disorders, visual disturbances, urinary and stool incontinence can be seen.
4. Blurring of consciousness and coma are observed in patients who have had bleeding and may be life-threatening. Sometimes the patient may lose consciousness within seconds and fall into a coma.
5. Some of the patients do not have any complaints and are detected incidentally.

Diagnosis

occurs into the brain and the surrounding cerebrospinal fluid-filled space, that is, into the subarachnoid space. The patient is often encountered in emergency clinics, sometimes in neurology clinics with seizures, sometimes in outpatient clinics with a simple symptom , and sometimes coincidentally . Both lesion and bleeding can be seen on CT or Brain MRI . CT- angio or MR- angio can be performed to see the vascular structures . One of the most sensitive examinations in which vascular structures are evaluated is DSA ( digital subtraction angiography ). With this radiological imaging, the vessels feeding the brain (arteries) and draining the blood ( veins and sinuses) and AVM can be seen with all the details, together with vascular pathologies such as aneurysm, if any.

Treatment

Shopping malls are graded according to their location and size. Low grade ones can usually be surgically removed. For large and deeply located AVMs that cannot be surgically removed stereotactic radiosurgery can be used. Gamma knife or Ciber AVMs can be closed over time with radiation treatments such as a knife . In endovascular treatment, it is entered through the inguinal artery and the AVM in the brain is filled with special substances, thus preventing the blood from filling here and bleeding. It can be applied to large and deeply located AVMs that cannot be surgically removed . The type of treatment is selected based on the location of the AVM , its size, the general health status of the patient, and the preference of the patient and the physician.