Arteriovenous Malformations of the Brain

Arteriovenous malformations (AVMs) occur when a group of blood vessels develops incorrectly, usually before birth or immediately afterward. The tangled arteries and veins then form indirect connections that bypass certain tissues. As a result, oxygen-rich blood may flow quickly and directly from an artery to a vein, causing the heart to work harder to keep up and depriving the bypassed tissues of essential oxygen and nutrients.

Because AVMs can arise in sensitive and difficult-to-access areas of the brain, their treatment is highly specialized. The globally acclaimed neurosurgeons in Tampa General Hospital’s renowned Neuroscience Institute and Skull Base Surgery Center offer world-class care for patients with cerebral AVMs and other complex brain conditions. As a nod to our commitment to innovation and outstanding outcomes, U.S. News & World Report has designated TGH as “high performing” in Neurology and Neurosurgery for 2023-24.

What Can Cause a Brain AVM?

Although scientists do not yet fully understand the causes of arteriovenous malformations, some experts believe there may be a genetic link. The risk of brain AVMs increases with certain inherited medical conditions, such as hereditary hemorrhagic telangiectasia (HHT).

What Are the Symptoms of a Brain AVM?

Many arteriovenous malformations go undetected because they do not cause symptoms. However, AVMs are at high risk of rupture. In some cases, the first sign is a brain hemorrhage.

In addition to bleeding, a cerebral arteriovenous malformation can cause:

• Severe headaches
• Seizures
• Muscle weakness or numbness
• Unsteadiness
• Vision problems
• Difficulty speaking and understanding speech

How Is a Brain AVM Diagnosed?

If an arteriovenous malformation is suspected based on the symptoms, a physician will typically perform a physical examination and order diagnostic testing, such as:

• Computed tomography (CT) – A series of X-ray images is used to create a detailed cross-sectional picture of the brain.
• Magnetic resonance imaging (MRI) – Powerful magnets and radio waves are used to create detailed images of the brain.
• Cerebral angiography – After inserting a long, thin tube (catheter) into an artery in the groin or wrist, the physician threads the catheter to the brain AVM using real-time imaging for guidance, then injects a dye to heighten the visibility of the feeding arteries and draining veins.

How Is a Brain AVM Treated?

The main goal of AVM treatment is to prevent hemorrhage. The approach can vary based on the location and size of the arteriovenous malformation and the patient’s age and general health. Some options include:

• Skull base surgery – After removing a piece of the skull to access the AVM, the neurosurgeon uses a high-powered microscope to visualize it, seal it with special clips and extract it from the surrounding brain tissues.
• Endovascular embolization – After inserting a catheter into an artery in the groin or wrist, the interventional radiologist threads the catheter to the brain AVM using real-time imaging for guidance, then injects an embolizing agent to block the feeding artery and reduce the flow of blood to the AVM.
• Stereotactic radiosurgery – A physician targets high-energy beams at the AVM to damage the blood vessels and cause scarring. The scarred vessels may then gradually clot off.

Choose TGH for World-Class Care

The neurosurgeons and otolaryngologists at TGH are internationally renowned for their expertise in skull base neurosurgery and continually rise to meet the challenges of the most complex cases. If you would like to explore your treatment options for a brain AVM with an expert on our team, contact us at (800) 822-3627 to schedule an appointment.