Arteriovenous malformations (AVMs) are tangles of abnormal blood vessels. They can form wherever arteries and veins exist, and can be found anywhere in the body. AVMs of the central nervous system (brain and spinal cord) have the most serious symptoms and complications.
Factors that may increase your chances of an AVM include:
Many times, symptoms may not be present. In those that have them, symptoms can vary from person to person. Symptoms depend on the size and location of the AVM.
An AVM in the brain may cause:
Serious complications of bleeding can lead to:
You will be asked about your symptoms and medical history. A physical exam will be done. Some AVMs are found during an imaging test for another reason.
Imaging tests are done to evaluate the brain and spinal cord. Contrast material may be used to make structures easier to see. These may include:
You may be referred to a specialist who has experience in treating AVMs. Treatment may in a specialized intensive care unit. The goal of treatment is to destroy or remove the AVM, and prevent further bleeding, which can lead to serious complications.
Treatment options vary depending on whether or not the AVM ruptured. A combination of therapies may be used.
Medications can also be used to treat complications associated with an unruptured AVM. These may include:
If the AVM ruptured, surgery may be delayed for 2-6 weeks. The type of surgery will depend on the size and location of the AVM. Surgical procedures include:
American Stroke Association
National Institute of Neurological Disorders and Stroke
Canadian Cardiovascular Society
Canadian Neurological Sciences Federation
Arteriovenous malformation information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/avms/avms.htm. Updated May 26, 2016. Accessed December 12, 2016.
Geibprasert S, Pongpech S, Jiarakongmun P, Shroff MM, Armstrong DC, Krings T. Radiologic assessment of brain arteriovenous malformations: what clinicians need to know. Radiographics. 2010;30(2):483-501.
Intracerebral hemorrhage. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115590/Intracerebral-hemorrhage. Updated October 28, 2016. Accessed December 12, 2016.
Ogilvy CS, Stieg PE, Awad I, et al. AHA Scientific Statement: Recommendations for the management of intracranial arteriovenous malformations: a statement for healthcare professionals from a special writing group of the Stroke Council, American Stroke Association. Stroke. 2001;32(6):1458-1471.
Seizure in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114746/Seizure-in-adults. Updated April 11, 2016. Accessed December 12, 2016.
Spinal cord arteriovenous malformations (AVMs). Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/neurologic-disorders/spinal-cord-disorders/spinal-cord-arteriovenous-malformations-avms. Updated October, 2016. Accessed December 12, 2016.
Vascular malformations of the brain. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113725/Vascular-malformations-in-the-brain. Updated June 24, 2016. Accessed December 12, 2016.
What is an arteriovenous malformation (AVM)? American Stroke Association website. Available at: http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/HemorrhagicBleeds/What-Is-an-Arteriovenous-Malformation-AVM_UCM_310099_Article.jsp#.WE7w2k2QwdU. Updated November 21, 2016. Accessed December 12, 2016.
Last reviewed June 2016 by Michael J. Fucci, DO, FACC