AVM (Arteriovenous Malformation), which can be expressed as a congenital vascular lump, is a vascular disorder that occurs in the brain during the development of the baby in the womb. While it does not cause any lifelong problems in some people, brain hemorrhage, epileptic seizures, headaches or some loss of neurological functions may occur in others. The most serious of these is the risk of brain hemorrhage.
This hemorrhage may be very small, the size of a lentil, and pass as a headache, or it may suddenly become a very large hemorrhage and cause death. It is not possible to predict how much bleeding an AVM will cause, so AVMs are a health problem of great importance.
The risk of a patient with an AVM suffering a brain hemorrhage is approximately four percent every year. In general, in order to calculate the probability of bleeding throughout life, it is necessary to subtract the patient's age from the number 105. For example; The lifetime risk of a 25-year-old person suffering from bleeding without treatment is calculated as 105-25 = 80. As a result, this person's lifetime risk of bleeding is eighty percent. Therefore, when an AVM is seen, especially in young people, it must be treated.
SYMPTOMS OF AVM
People with AVM may experience symptoms such as headache, dizziness, numbness, and epileptic seizures. . Additionally, vomiting and fainting may occur suddenly. Apart from these, when an examination is requested due to a condition such as sinusitis, it may be discovered that the person has an AVM by chance. There are also groups of patients in whom it does not show any symptoms.
On the other hand, 10-20 percent of patients with AVM experience epileptic seizures. In this case, the patient must use anti-seizure medications. It is not known in advance when and under what conditions seizures will occur.
TREATMENT OF AVM
There are three medical methods for the treatment of AVM; To remove the AVM by surgery, to prevent possible bleeding by entering the vein with a catheter and injecting an occlusive substance into the AVM, or to apply Gamma Knife Radiosurgery...
When deciding which of these three methods will be used for the patient; patient's age, clinical findings in the patient, location, size, vascular characteristics of the AVM (feeding vessel Many factors are taken into consideration, such as the structure of the veins that send blood from the AVM. As a result, the patient is told which method or methods are suitable for him/her. It is necessary to inform every patient about the options available in treatment. The advantages and disadvantages of the methods are explained. The doctor also conveys his opinion to the patient about which method is most suitable and correct for him. In the light of all this information, the doctor plans the treatment together with his patient.
In surgery, the procedure involves entering the brain and removing the vascular lump from the area where it is located. During this entry, risks of damaging the surrounding brain tissue or a healthy vessel and disrupting its function (such as paralysis, blindness, etc.) may occur. Therefore, not every AVM can be treated with surgery.
After radiosurgery, it takes three years for the AVM to disappear completely. The patient should be monitored regularly, there is a risk of bleeding until the AVM disappears completely. Over three years, as the vascular lump gradually shrinks, the risk will decrease and eventually disappear. If the AVM is small and in a location that can be easily reached by surgery, and the risks of surgery appear to be less for the patient, surgery is preferred. Thus, the risk of bleeding after surgery (if all of them can be removed) is eliminated. However, when a patient who applied for a simpler disease or complaint but was diagnosed with AVM is suddenly asked to undergo surgery, the patients naturally do not want this and prefer non-surgical methods.
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