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Knowing AVM Brain: Causes of headaches, convulsions, and strokes

Arterial malformations, or abbreviated AVMs, are a group of abnormal blood vessels that are interconnected with each other. AVM can occur in different limbs, but the brain AVM is the most problematic. Another term AVM is the arteriovenous fistula.

To understand the reasons why AVM is dangerous, it is first important to understand how normal blood vessels are related to each other.

Normal arterial and venous relationships

There are two main types of blood vessels: arteries and veins. Arteries carry blood rich in oxygen from the heart and lungs to other parts such as muscles, bones, and brain, while the veins bring back blood to the heart and lungs to get the oxygen back. As the arteries move deeper into the tissues of the body, they become smaller and smaller, until they reach the maximum narrowing point - this part is known as capillary. Blood flow slows down to be transferred from artery to vein.

Thus, one of the important functions of capillaries is to relieve some of the pressure that is concentrated on the blood as it flows through the larger arteries into the tissues.




The vein exits the capillary and progressively enlarges as it exits the organ on its way back to the heart and lungs to add oxygen.

Abnormal arterial and venous connections

The brain AVM is derived from arteries and veins that are connected in the absence of capillaries. This causes pressure on the arteries when switching directly to the vein within the AVM range. This rare blood stream produces parts that have high pressure and turbulence and cause the AVM to enlarge over time, as well as affect the function around the brain tissue.

What does AVM look like?

AVM brain varies in shape. Some are usually small and invisible for decades. Others form large and tortuous channels in the arteries, which pulsate strongly because they are connected directly to the vein. AVM can be found anywhere in the brain, including the cerebral cortex, white matter, and brain stem.

Who has the potential to experience AVM brain?

AVM of the brain affects about 0.1% of the population, some even begin at birth, but rarely affect more than one member of the same family. They are equivalent in men and women. People generally start feeling symptoms between the ages of 10 and 30 years, but rarely occur in those over the age of 50 years.

What are the symptoms of AVM?

About half of patients know the AVM after undergoing subarachnoid hemorrhage. The other half were affected because of convulsions, headaches, and stroke symptoms such as hemiplegia or hemiparesis.

How to diagnose AVM?

The diagnosis of AVM is often performed by a radiologist only with a brain CAT scan. However, most doctors feel more comfortable performing an AVM diagnosis after performing an MRI examination. In cases where bleeding occurs, the AVM can be completely blocked by intracerebral hemorrhage, requiring a cerebral angiogram to determine the final diagnosis.

How to handle AVM?

The most common types of treatment available include surgical resection, endovascular embolization, and stereotactic radiosurgery, all of which can be used either alone or in combination. In general, this treatment aims to reduce the risk of bleeding, and prevent re-bleeding.

The issue that is currently under intensive research is whether doctors should treat AVM before causing bleeding. Apparently, no study assessed the risk of bleeding when the AVM was ruptured and occasionally the symptoms of AVM were not treated. Some people even believe that AVMs found before bleeding have a lower risk than those found after bleeding. Nonetheless, uncertainty causes many surgeons and patients to decide to perform surgery, regardless of the risk that the act itself can cause permanent brain injury.

What about the prognosis?

The prognosis of AVM depends on several factors, starting with whether the AVM is found before or after bleeding. More than 90% of those who experience bleeding can be saved after the incident. In those with AVM found before the bleeding, the prognosis is directly related to the size of the AVM, the symptoms, the proximity to the vital areas of the brain and, as noted above, whether treatment is done or not to AVM.





References

References

Allan H. Ropper, Robert H. Brown, Adams and Victor’s Principles of Neurology, 8th Edition (McGraw-Hill)

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Is a health and wellness enthusiast. In him free time, she loves to travel and taste different types of teas.

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