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.

 

artmalf pre   artmalf post
Pre   24 months post