Arteriovenous Malformation (AVM)

Condition/Diagnosis: Arteriovenous malformation (AVM)

Overview: Due to this condition arteries and veins in your brain get tangled and prevent the exchange of oxygen rich blood into the organs, in this case the brain. What happens in a regular functioning body is that blood-carrying oxygen enters your brain through a set of blood vessels then passes through a set of smaller blood vessels and eventually into tiny blood vessels called capillaries, which allow the oxygen-rich blood to be used, by the brain. If you have AVM the blood ignores the vital capillary step in a sense and ultimately causes no absorption of oxygen and potential rupture of blood vessels and bleeding in the brain.

Symptoms/Warning Signs: This disease could develop before you are even born and may be unnoticed until symptoms appear. Symptoms are:
-A whooshing sound (bruit) that can be heard on examination of the skull with a stethoscope or may be audible if you have an AVM
-Progressive weakness or numbness
-Vision loss
-Difficulty speaking
-Inability to understand others
-Severe unsteadiness

Microsurgical resection — the most common treatment is done by performing a craniotomy (removing a part of the skull in order to access the brain) and removal of the AVM from the brain or spinal cord using a microscope.

Stereotactic radiotherapy — a more recent technique for the treatment of AVMs. It is also known as “stereotactic radiosurgery.” During this treatment, we deliver a concentrated dose of radiotherapy to the core of the AVM in one session. Over the course of 2 to 5 years, the vessels of the AVM clot off and the AVM shuts down.

Endovascular embolization — also a more recent technique for the treatment of AVMs. During this treatment, we pass a catheter through the groin up into the arteries in the brain that lead to the AVM and inject a material into these arteries. This injection shuts off that artery and reduces the flow of blood through the AVM. Endovascular embolization by itself typically does not eliminate the AVM and is therefore almost always used as a preliminary step in preparation for either microsurgical resection or stereotactic radiotherapy.

The surgeons at Colorado Brain and Spine Institute will meet with a team of doctors to determine the best treatment option for the patients with AVMs.