Arteriovenous malformation
Definition and Presentation
A collection of abnormal blood vessels instead of a capillary
bed between the supplying arteries and the draining veins is called
an arteriovenous malformation (AVM). In most patients it is
congenital but it can probably also develop after birth. More than
60% of AVMs present with a haemorrhage causing anything from a
moderate headache to severe neurological deficits and even death.
Prevention of another haemorrhage is usually the main reason for
treating this condition. Focal or generalised epilepsy is also a
common mode of presentation. More rarely the lesion presents itself
by causing a transient neurological disturbance.
Diagnosis
MRI, but detailed evaluation is by angiography before the type
of treatment is decided upon.
Treatment
The most important treatment for AVM is still microsurgical
removal. Treatment by Gamma Knife surgery should be restricted to
small to moderate size AVM in eloquent locations. A third treatment
alternative is embolisation. The latter often requires additional
treatment and Gamma Knife surgery is then often preferred.
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24 months post |