An arteriovenous malformation (AVM) is an abnormal connection between arteries and veins, resulting in a “tangle” of blood vessels in the brain and spinal canal. In normal circulation, blood flows from arteries to capillaries and then to veins, taking blood from high pressure to low pressure gradually. However, in AVMs, blood flows directly from arteries to veins through an abnormal passageway called a fistula, rather than through capillaries. This leads to downstream effects, including increased flow and pressure. Over time, the vessels fatigue, leading to rupture. The injury can endanger physical and neurological functions -- such as sight, sensation, critical thinking and movement -- that are associated with that area of the brain. A rupture also can be fatal.
Some brain AVMs come to attention in ways other than bleeding, such as seizure. The majority of patients are between 20 to 50 years of age when a brain AVM comes to be diagnosed. However, brain AVMs can affect people of any age.
Nirav J. Patel, MD, Neurosurgeon at Brigham and Women’s Hospital, discusses the treatment and approach to care for an Arteriovenous Malformation (AVM) diagnosis.
This tangle of arteries and veins usually develops before birth or shortly after. Occasionally, an AVM forms later in life, though it is unclear if the risk for an AVM is passed down through families genetically. For someone with an AVM, an increase in blood pressure is a risk factor for rupture.
Most people who have an AVM may be unaware of the abnormality and experience no symptoms. Some brain AVMs present with symptoms including:
Women with AVMs can sometimes develop symptoms during pregnancy.
A team of specialists at Brigham and Women’s Hospital Center for Cerebrovascular Diseases (including neurosurgeons, endovascular surgeons, neurologists and radiation oncologists) collaborate to determine the best treatment for each AVM. The best treatment depends on the AVM’s location and anatomy and the decision is centered around the patient, to achieve a cure with the least risk.
For more detailed information, see more information on treatment of Arteriovenous Malformations.
To schedule an appointment with a physician in the AVM Program at the Center for Cerebrovascular Diseases, please contact our Patient Coordinator at: (617) 732-6600. We see new patients with AVMs as soon as the next business day.
If you are a physician seeking to refer a patient to the Center for Cerebrovascular Diseases, please call (617) 732-6600 or you can access our physicians’ office phone numbers. To contact one of our physicians with a question, patient referral or second opinion, you may also email: BWHNeurosurgery@partners.org.
For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery.