Neuroscience offers several treatment options for arteriovenous malformation (AVM). Symptoms such as headache and seizures may be alleviated with medication, but due to the potential danger of hemorrhage, leaving the AVM itself untreated carries some level of risk. The most common treatment option for an AVM is surgical intervention; however, surgery on the central nervous system always carries risks that the doctor will weigh carefully against the benefits in advising the patient.
How are Arteriovenous Malformations Treated?
Over the long-term, about 2 to 3 percent of AVMs bleed each year. In developing a treatment strategy, the doctor will look at the results of an MRI or CT Scan, the size of the AVM, the patient’s symptoms and age, and if a pregnancy is involved or planned. If the results indicate a higher than usual risk of a large hemorrhage, surgery is usually required.
Doctors have three treatment options for AVM when brain surgery is the prescribed course of action: conventional surgery, endovascular embolization, and stereotactic radiosurgery.
- Conventional surgery removes the AVM seeking to cause as little damage as possible to surrounding tissue. It is most used if the AVM is small and located close to the surface of the brain. Those deeper in the brain tissue cannot be reached with conventional surgery due to the high risk of damage to important areas of the brain.
- Endovascular embolization utilizes a catheter that the doctor guides through the arteries to insert a plug that blocks the fistula, the abnormal opening that allows blood to flow improperly between arteries and veins. The embolization is frequently used in conjunction with conventional surgery or radiosurgery to help improve the safety of surgery.
- Stereotactic radiosurgery is one of the most technically advanced, non-invasive brain surgery procedures available. Highly focused beams of radiation close the AVM, while not damaging surrounding tissue. Stereotactic radiosurgery is performed at centers such as the Florida Hospital Neuroscience Institute where physicians utilize the Leksell Gamma Knife® 4C.
Each case is unique, and patients are encouraged to consult with a neurologist as soon as symptoms appear and to become informed about the benefits and risks of treatment options for AVM.