AVM Treatment
Arteriovenous malformations (AVMs) are abnormal tangles of blood vessels in the brain where arteries connect directly to veins, bypassing the normal capillary network. Our expert endovascular team uses advanced embolisation techniques to safely treat these complex conditions and prevent life-threatening bleeding.
Understanding Brain AVMs
A brain AVM is a congenital vascular anomaly where arteries connect directly to veins without the normal capillary bed in between. This creates a high-flow 'nidus' that can rupture and cause brain haemorrhage. AVMs can also cause seizures, headaches, and neurological deficits by stealing blood flow from surrounding brain tissue. While relatively rare, AVMs carry a 2-4% annual risk of rupture, making treatment an important consideration.
Signs & Symptoms
Seizures (often the first symptom)
Sudden, severe headache from haemorrhage
Progressive neurological deficits (weakness, numbness, speech difficulty)
Pulsatile tinnitus (whooshing sound in the ear)
Vision problems
Many AVMs are discovered incidentally on brain imaging
How AVM Embolisation Works
Diagnostic Angiography
Detailed cerebral angiography to map the AVM's feeding arteries, draining veins, and nidus architecture. This information guides the treatment strategy and risk assessment.
Staged Embolisation
A microcatheter is navigated into the AVM's feeding arteries. Liquid embolic agents (Onyx, glue) are injected to block blood flow through the abnormal vessels. This is often done in stages over multiple sessions.
Multimodal Treatment
Depending on AVM size and location, embolisation may be combined with stereotactic radiosurgery (focused radiation) or microsurgery for complete obliteration.
Follow-Up Imaging
Regular MRI and angiographic follow-up to assess AVM obliteration progress. Complete treatment confirmation requires follow-up angiography.
Recovery After AVM Treatment
Recovery depends on the treatment modality and AVM complexity. Endovascular embolisation typically allows faster recovery compared to open surgery.
1-3 Days
Hospital stay for observation after each embolisation session. Neurological checks and imaging.
2-4 Weeks
Return to normal activities between staged embolisation sessions. Anti-seizure medication if prescribed.
6-12 Months
For radiosurgery, gradual AVM shrinkage occurs over months. Regular imaging follow-up.
1-3 Years
Complete AVM obliteration confirmed by angiography. Continued monitoring as recommended.
Frequently Asked Questions
Can all AVMs be treated?
Most AVMs can be treated, but the approach depends on size, location, and drainage pattern. Some small, deep AVMs in non-critical brain areas may be observed. Our team uses the Spetzler-Martin grading system to assess each case.
How many sessions are needed?
Small AVMs may be treated in a single session. Larger ones typically require 2-4 staged embolisation sessions spaced weeks apart, sometimes followed by radiosurgery.
What happens if an AVM ruptures?
AVM rupture causes brain haemorrhage — a medical emergency. Emergency treatment focuses on stabilisation, blood pressure control, and potentially emergency surgery or embolisation. This is why preventive treatment of high-risk AVMs is important.
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Need Expert Consultation?
Dr. Hilal Ahmad Ganaie and the team are here to help. Book an appointment or reach out via WhatsApp for immediate assistance.