Arteriovenous Malformations - Medical Malpractice Lawyers

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Arteriovenous Malformations - Medical Malpractice

Arteriovenous malformations usually occur in the brain and involve an unusual and abnormal connection between the veins and the arteries. It usually occurs from birth, making AVMs congenital but the symptoms don't tend to come until later in life. Arteriovenous malformations can also occur in other body areas, particularly in the spine. The cause of an AVM is completely unclear.

Many people do not know they have an arteriovenous malformation until they experience symptoms. Seizures can be a major symptom as can headaches. There can be rupture of the arteriovenous malformation, which can lead to brain hemorrhage and bleeding. This can be very dangerous and even deadly. If diagnosed early enough, however, the AVM can be treated so that the bleeding complication does not occur.

The signs and symptoms of an AVM within the brain include a bruit or swooshing sound heard when examining the skull with a stethoscope. You can have seizures that come on all of a sudden. Headaches can occur and there can be progressive numbness or weakness of the body because of the AVM. There can be stroke-like symptoms including a sudden headache, which is severe, paralysis of one side of the body, tingling or numbness on one side of the body or one limb, loss of vision, difficulty speaking or understanding the spoken word and uncoordination.

The symptoms usually come up before the age of 50. The AVM can cause damage to the brain if not treated in time. Symptoms are common in young adulthood. If you have an AVM and reach middle age, the AVM becomes more stable and you often have resolution of your symptoms. Symptoms can show up during pregnancy because of the increase in blood volume and blood flow during pregnancy.

Arteriovenous malformations tend to occur during foetal development. Exactly why this occurs is not clear. In a brain AVM, the blood passes from the arteries to the veins via vessels that are abnormal and are not capillaries. It changes the way blood flows through the veins in your brain and you have problems with getting circulation to nerve cells in the area of the AVM.

Risk factors for arteriovenous malformations include being of a male gender and having a family history of AVMs. It isn't known exactly how the genetic influence goes in such cases.

The diagnosis of an arteriovenous malformation usually requires the skill of a neurologist and a radiologist who can read scans of the brain. One test is called a cerebral arteriography or cerebral angiography. This is a detailed test that shows AVMs very clearly. Dye is sent up to the brain and x-rays look for the AVM. It is easy to see an AVM via this method. Another test is a CT scan of the brain. Dye can be injected into the vein before the test to show the arteries and veins more easily. This is then called a CT angiogram. An MRI scan of the brain can also show up an AVM. It is a more sensitive test than a CT scan of the brain so the images are easier to see. An MRI can show the exact location of the AVM, which can help doctors decide on a treatment. Dye can be injected into the brain and an MRI scan can be done in what's called an MRI angiography test.

Treatment of an AVM depends on the symptoms a person has and on the size and location of the AVM. Surgical removal is the treatment of choice and involves removing a section of skull, finding the AVM and using a microscope to find and remove the AVM using suture and usual surgical technique. It is done whenever the risk of bleeding is higher than the risk of doing the surgery.

Another procedure is called endovascular embolization, which means that a tube is inserted into the leg and is threaded up into the AVM. A glue-like material is injected into the AVM in order to block blood flow through the AVM. The AVM then "dries up".

Stereotactic radiosurgery uses precisely focused radiation. The radiation can kill off the AVM, which slowly clots itself off. It works best when the situation isn't life threatening and you have the time to allow the AVM to clot off.

The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here