Posted by An arteriovenous malformation (AVM) is a tangle or jumble of arteries and veins that were formed incorrectly before birth. These malformations bypass a capillary system which can cause a person with an AVM to experience all kinds of symptoms that can eventually be fatal. In this essay I will talk more about those symptoms, the effects that they have on the brain, and how they can be treated.
In a normal situation, the deoxygenated blood travels into the right ventricle from the right atrium. This blood is then pumped through the pulmonary trunk and into the lungs through the pulmonary arteries. The carbon dioxide/oxygen exchange occurs and the now oxygenated blood returns to the heart’s left atrium through the pulmonary veins. It then travels to the left ventricle where it is then transported to the rest of the body to deliver oxygen, nutrients, and collect waste products. There are capillaries found between the arteries and veins, acting as a bridge that aids in nutrient exchange and oxygen delivery. This abnormal connection of the arteries directly to the veins disrupts the pressure and can cause inadequate blood flow and oxygen to the brain, possibly resulting in tissue and nerve death.
One of most common symptoms of an AVM are seizures. It represents the second most common revealing condition (the most common being the hemorrhage) among all the bAVM patients. (Guillaumet et al., 2022) Other symptoms can include headaches, pain, problems with vision, speech, memory and movement. There is a chance that one would not experience any symptoms. Sometimes people do not realize they have an AVM until after it ruptures. Symptoms after a rupture can include worsening of previous symptoms as well as new ones like loss of consciousness, weakness or numbness, vomiting, and nausea. These all should prompt one to seek medical attention because the prolonged effects of a rupture will, in most cases, result in death if left untreated. Most of the time, your body’s immune system does not usually react to an AVM until after it has ruptured, and in those cases, the body goes into overdrive trying to repair itself as quickly as possible.
Arteriovenous malformations are either diagnosed before rupture or after rupture, though most AVMs are diagnosed on rupture. (Joud et al., 2020) Medical imaging such as magnetic resonance imaging (MRI), computed tomography (CT) scans, even catheter angiography, which is a catheter that is inserted into an artery to examine one’s blood vessels, is used to detect if and where the AVM is could be located. The treatment options differ from patient to patient because of different factors like age, the location and progression of the AVM, symptoms, risk of rupture, and one’s overall health. Surgery can be done to remove the AVM entirely or to reduce the chance of it rupturing and bleeding. Other procedures like embolization or radiosurgery have proven to be successful at stopping the blood from flowing into those veins and arteries; however, surgery on any part of the brain or spinal cord carries some risk of serious complications or death. (National Institute of Neurological Disorders and Stroke, 2024)
In conclusion, arteriovenous malformations are complex deformities that can be life-threatening if gone untreated. While some AVMs can be asymptomatic, their potential rupture can cause severe damage and require immediate treatment for the best possible outcome. The more we understand about them and know the symptoms of AVMs, the better prepared we can be to support and help those affected by them.
References
Guillaumet, G., Shotar, E., Clarençon, F., Sourour, N.-A., Premat, K., Lenck, S., Dupont, S., Jacquens, A., Degos, V., Boeken, T., Nouet, A., Carpentier, A., & Mathon, B. (2022). Incidence and risk factors of epilepsy following brain arteriovenous malformation rupture in adult patients. Journal of Neurology, 269, 6342–6353. https://doi.org/10.1007/s00415-022-11286-6
Joud, H., Peto, I., Noureldine, M. H. A., Mokin, M., & Agazzi, S. (2020). Spontaneous regression followed by rupture of an untreated brain arteriovenous malformation. World Neurosurgery, 143, 290-294. https://doi.org/10.1016/j.wneu.2020.07.162
National Institute of Neurological Disorders and Stroke. (2024, July 19). Arteriovenous malformations (AVMs). National Institutes of Health. https://www.ninds.nih.gov/health-information/disorders/arteriovenous-malformations-avms
Cleveland Clinic. (n.d.). Arteriovenous malformation (AVM): Causes & symptoms. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/16755-arteriovenous-malformation-avm
