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Arteriovenous Malformations
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Correcting Brain Arteriovenous Malformations
Brain arteriovenous malformations are collections of non-standard blood vessels which develop in the brain. They include a blood vessel "nidus" (or nest) where the arteries connect directly to veins, instead of through the complex collection of very small vessels called capillaries. Brain arteriovenous malformations can occur in any area of the brain, and may be either small or large. If they hemorrhage, they usually do so with a limited amount of blood, unlike the hypertensive hemorrhages of other stroke patients. Loss of function varies depending on both the location of the brain arteriovenous malformations and the amount of bleeding. Many patients have very small hemorrhages, often multiple. They experience convulsions before even knowing about the presence of brain arteriovenous malformations. Some patients suffer with headaches, often unrelated to the brain arteriovenous malformations which are usually found with a CT scan or brain MRI. In only a few instances, children are born with large brain arteriovenous malformations and may experience heart failure because the malformation makes the heart work beyond its capacity.
These lesions are surrounded by a very discrete layer of abnormal, nonfunctioning brain tissue, thus allowing their removal with relative safety to the surrounding brain. This factor is of the utmost importance to the brain surgeon, who can take advantage of this natural separation between normal brain tissue and the abnormal vascular malformation.
The surgery for brain arteriovenous malformations or any other condition of the brain is serious and you will want the best of care. That is the reason you need to consider a trip to Panama City, Panama and Hospital Punta Pacifica.
The Procedure
There are three different methods of treating brain arteriovenous malformations; radiation, embolization and invasive surgery. A patient’s symptoms and the location of the brain arteriovenous malformation dictate which method is employed by the neurosurgeon.
Radiation
If there is a very small brain arteriovenous malformation that is deep within the brain, the patient is considered fortunate. It is possible to give focused beam radiation to the malformation, and avoid surgery. In cases such as these, the malformation will most likely disappear within two years.
Embolization
Larger malformations may be surgically corrected with a technique called embolization. With this procedure an angiogram becomes a therapeutic tool much like the procedure for correcting an aneurysm. An angiogram is capable of filling the malformation in order to eliminate the blood supply to the malformation. This surgery is the easiest alternative in some cases and has performed successfully.
Surgery
If treatment is deemed necessary and the other methods are not considered to be options, invasive surgery is required. Microsurgical resection, due to advances in microscopic visualization, computer assisted stereotactic guidance and electrophysiologic monitoring, has become a much safer and successful procedure. When possible to perform, surgical resection is the preferred method of treatment because it provides an immediate and permanent elimination of the risk of hemorrhage, improvement in neurologic function, and a decrease in the incidence of seizures. The disadvantage is that it requires an open operation, meaning that the skull is opened and the surgeon has a clear view of the affected region.
After your surgery
Your recovery will be directly related to the type of procedure that you have to treat you brain arteriovenous malformation. Recovery from radiation will be similar to other radiation treatments and the AVM will likely disappear in two years or less. Recovery from embolization is rapid and the results are almost immediately known. While surgery requires an open cranial procedure, microsurgical resection is greatly reducing the effects of this procedure.
Risks
Surgical risks with a brain arteriovenous malformation procedure are similar to other intracranial treatments; stroke, loss of function in other areas of the body and even death. Loss of function is dictated by the area of the brain affected by the brain arteriovenous malformation.