A brain or spine AVM may not cause any symptoms until a rupture occurs however some
people may experience symptoms depending on the location of the AVM. Some signs
and symptoms of a brain AVM may include seizure, weakness, numbness or headache,
typically in one area of the head. Some symptoms may be severe. A spine AVM may
cause weakness in the arms or legs, numbness and balance problems.
AVM treatment is based on the location, size and position of the draining vein associated
with the AVM. Each patient will have a treatment plan specific to their AVM to ensure
care is given to tending to the delicate nature of this condition. The first step
in developing a treatment plan is to obtain a Cerebral Angiogram. A Cerebral Angiogram,
also known as digital subtraction angiography (DSA), is a minimally invasive sterile
procedure performed using fluoroscopy (live X-Ray).
A small tube called a catheter is used to access the femoral artery which is located
in the groin or the radial artery at the wrist. The catheter is advanced over a
guidewire to select vessels through which contrast is injected to obtain images.
Treatment options for your AVM will be discussed during your visit. In general treatment
can consist of embolization – injecting a special glue into the AVM followed by
surgical resection or stereotactic radiosurgery which uses highly accurate and concentrated
dose of radiation to obliterate the AVM over time. Limited number of highly selected,
small AVM can be treated with embolization only. The type of treatment depends on
the location, size and location of feeding and draining vessels. Some of the AVM
are observed over time with imaging rather than treated due to high risk of treatment
or low lifetime risk of hemorrhage.
Endovascular treatments are performed from within the vessel, typically accessed
at the femoral artery located at the groin or radial artery at the wrist from which
catheters are advanced over a small wire to the AVM. In this procedure a glue-like
material is injected into the AVM cutting off the blood supply. Sometimes more than
one treatment session is needed to block off majority or all of the feeding vessels.
An open surgery, called a Microsurgical Resection, may be the treatment of choice
for your AVM either in conjunction with endovascular embolization or as the primary
treatment. This will be discussed at the time of your appointment.