Arteriovenous Malformations
Arteriovenous malformations (AVMs) are abnormal tangles of blood vessels that bypass capillaries, potentially leading to tissue damage and increased risk of hemorrhage.
Overview
Arteriovenous malformations (AVMs) are defects in the vascular system, which is the body's network of blood vessels. This system includes:
- Arteries, which carry oxygen-rich blood from the heart to tissues and organs.
- Veins, which carry blood and waste products back to the heart.
- Capillaries, which are tiny blood vessels connecting small arteries to small veins.
An AVM is an abnormal tangle of arteries and veins connected directly to each other, with no capillaries in between. Without capillaries, blood flows from arteries directly into veins at a faster rate than normal. This rapid flow prevents nearby tissue from receiving adequate oxygen, which can lead to tissue damage and the death of nerve cells and other cells. Additionally, the fast rate of blood flow can increase blood pressure inside the arteries and veins, weakening them. A weakened artery or blood vessel could burst or leak blood.
Causes & Risk Factors
AVMs are rare, and the specific cause is unknown. Most people are born with them, but they can sometimes appear shortly after birth or later in life.
Symptoms
Symptoms depend on the location of the AVM. While they can occur anywhere in the body, they are more common in the brain or spinal cord. Most people with brain or spinal cord AVMs have few, if any, major symptoms. However, if a weakened blood vessel bursts, it can spill blood into the brain, a condition called a hemorrhage. Severe hemorrhages can cause a stroke and brain damage.
If an AVM is causing symptoms, they may include:
- Seizures
- Headache
- Pain in the area where the AVM is located
- Vision problems
- Muscle weakness
- Problems with movement and speech
- Confusion
- Dizziness
- Loss of consciousness
Diagnosis
To determine if you have an AVM, a health care provider will typically:
- Ask about your symptoms and medical history.
- Perform a physical exam, which may include listening for a bruit. A bruit is a whooshing sound caused by rapid blood flow through the arteries and veins of an AVM.
- Order imaging tests, such as a CT scan, MRI, ultrasound, or cerebral angiography. For a cerebral angiography, a special dye is injected to help blood vessels in the brain show up on x-rays.
Treatment & Management
Treatment options depend on several factors, including:
- The location of the AVM
- Its size
- Your symptoms
- Your overall health
- Your risk of bleeding
Possible treatments include:
- Monitoring for signs of an increased risk of hemorrhage.
- Medicines to help manage symptoms associated with AVMs.
- Surgery, which may be performed if there is a higher-than-usual risk of bleeding. There are various types of surgery for AVMs, and in some cases, more than one type may be required. Surgery can be risky, particularly when performed on the brain or spinal cord, so it is important to discuss the risks and benefits with a provider before making a decision.