How Are AVMs and Other Lesions Treated?

There are several treatment options available for AVMs or arteriovenous malformation and the choice of treatment largely depends on the likelihood of subsequent hemorrhage. If the AVM is small in size and arterial feeding pressure is high along with a history of a previous hemorrhage makes a patient more eligible for one of the treatments discussed below.

Anticonvulsants

This type of medical therapy is more suitable to control seizures that often appear as the first symptom of a brain AVM. Medicines like phenytoin, valproic acid, and carbamazepine are mostly prescribed for these patients. Those who have an AVM but never had a seizure are given treatments other than anticonvulsants.

Headache management

Man with headache imagePatients who have been diagnosed with an AVM are told to closely monitor the onset of headaches. Acute onset could be an indication of impending hemorrhage, but if there is no risk of intracranial hemorrhage the patients are told to manage headaches by using analgesics or pain killers prescribed for migraines.

Conventional surgery

If an AVM is surgically accessible and is small in size, it is advisable to get rid of it through surgical intervention. A conventional approach is usually employed if there is a low risk of complications. Spetzler-Martin grading system is usually used to determine if conventional surgery would be an appropriate treatment choice. AVMs of grade IV and V are not responsive to surgery; whereas, grade I and II AVMs are usually the most reasonable candidates for surgery.

Radiosurgery

Small AVMs are more likely to burst and cause bleeding in the skull. If they are less than 3cm in diameter, a procedure called radiosurgery is usually recommended for their treatment. There are three types of radiosurgery procedures currently in use;
– Proton beam
– Linear accelerator
– Gamma knife
These methods are used to give radiation to the location where the AVM is found. It is important to safeguard the surrounding healthy brain tissues from these powerful radiations. Patients, who have already gone through another procedure called embolization, are usually not treated with radiosurgery because the process becomes even more difficult in such a case than it already is.

Endovascular embolisation

This treatment is used to block the high-speed blood flow from high-pressure arteries to veins because there are no capillaries to slow down this stream. It is done by delivering various thrombosing agents into the AVM nidus, which include acrylate glue, onyx liquid embolic fluid, or thrombus-inducing coils. It is recommended to use the multi-stage approach for safety and long-term effectiveness.

Why is it Important to Get Treatment?

Treating AVMs is important to minimize the risk of a hemorrhage, which can be life-threatening. Moreover, people who experience regular signs and symptoms of brain AVMs, such as headaches and seizures as well as some psychological disorders and personality changes, can get relief from these conditions if they undergo surgery for the removal of AVM or choose another treatment option to improve the quality of their life. Also arteriovenous malformation can be dangerouse when it comes to driving.

Can AVMs be Prevented?

AVMs cannot be prevented as their cause is still unknown to doctors. The lesions are present at birth, means they are congenital; however, not hereditary. Although there is no way to prevent them, one may take precautionary measures to minimize the risks associated with a brain or spinal AVM and to get relief from some of the symptoms that affect the overall health of the patient. Prevention is possible with early diagnosis and therefore if you experience any of the common signs of a brain or spinal AVM, it is strongly advised to undergo one of the imaging or scanning tests to diagnose an AVM and devise an appropriate treatment plan.