
An Arterio-Venous Malformations (AVM) is a tangle of abnormal and poorly formed blood vessels (arteries and veins), with an innate propensity to bleed.
AVMs of the brain and spine are congenital (present at birth) and relatively rare. They affect both men and women at about the same rate. They can occur at all ages, but most often cause symptoms between 20 and 40 years of age.
An AVM can occur anywhere in the body, but brain and spinal AVMs present substantial risks when they bleed. Because the brain and its blood vessels are formed together during embryological development, abnormal blood vessel formation is often associated with abnormal brain tissue. A person with an AVM may experience no symptoms.
.AVMs can irritate the surrounding brain and cause seizures or headaches. The most common symptom is brain haemorrhage.
Treatment :
Surgery is the most common approach. The surgical procedure is performed neurosurgeons and their teams.
The three types of treatment available include direct removal using microsurgical techniques, stereotactic radiosurgery, and embolization.
Diagnosis:
AVMs are identified by the scan of the brain by magnetic resonance imaging (MRI). Further information is obtained by performing a cerebral angiography to understand its size, shape, exact location and pattern..
Technique:
The surgery is performed under general anaesthesia. Opening of the skull ((craniotomy) is performed and the AVM is carefully cut out from the surrounding brain. This is an intricate surgery and can take several hours.
The skull is stitched and patient is kept under observation in the Neurosurgical Intensive Care Unit. The normal hospital stay is around 1 week and a repeat angiogram is performed to ensure the AVM is completely removed.
Patient needs to be rest and recover at home for at least 2 months.
Many patients undergoing microsurgery make an excellent and quick recovery after several days of hospitalisation.
Due to the complete removal of the AVM, protection against haemorrhage (bleeding) is prevented. Once this procedure is performed no other treatment shall be required in future in most of the cases.