Arteriovenous malformation (AVM)

Arteriovenous malformation is abnormal tangle of vessels which can rupture and can give life threatening condition to the patient.

Normally, arteries branch into capillaries and the capillaries join each other to form veins. In AVM these capillaries are not normal and are ill-formed, and thus are prone to rupture easily.

Depending upon size, place and depending upon drainage of AVM they are classified as:

Grade 1, Grade 2, Grade 3, Grade 4, and Grade 5

 

Spetzler- Martin Grades of AVM

Size

< 3cm

1

3-6 cms

2

>7cm

3

Eloquence

Non-eloquent

0

Eloquent

1

Venous drainage

Superficial System

0

Deep System

1

 

Symptoms

Can be headache, seizures, weakness in the limbs, unconsciousness and even death.

Treatment options

  1. Surgery- Directly deals with the lesion and ivolves excision of AVM.
  2. Endovascular embolization- Injection of liquid embolic material to reduce blood flow and sometimes complete occlusion of AVM.
  3. Radiation- It burns the AVM over period of 2 years. Large AVM can be dealt in staged manner.
  4. Close observation- especially for Grade 4 and 5 which are too risky to intervene.

 

 

AVM Case 1

9 yrs girl presented with headache and left side weakness.

She was diagnosed with Right perieto-occipital AVM. MRI Brain showed Right parieto-occipital AVM. Fig 1 and 2

Incision
Exposure
After craniotomy
After excision
AVM