What is an arteriovenous malformation?
An arteriovenous malformation (AVM) is a condition where a group of tangled, abnormal blood vessels affect how blood flows between your arteries and veins. AVMs are most commonly found in the brain and spinal cord, but can also occur in other parts of the body.
Normally, arteries carry oxygen-rich blood from the heart to the body's tissues, and veins return the blood back to the heart and lungs. Tiny blood vessels called capillaries help with this process by slowing blood flow and allowing oxygen to reach nearby tissues. But in an AVM, the capillaries are missing, so blood moves too quickly from arteries to veins without delivering oxygen where it's needed. This can lead to tissue damage and, over time, may cause the AVM to grow larger.
Many people with an AVM in the brain or spinal cord don’t have noticeable symptoms. However, in some cases, the abnormal blood vessels can weaken and rupture, causing bleeding in the brain (a hemorrhage), which can lead to a stroke or other serious complications. AVMs are often found by chance during tests for other health conditions.
Arteriovenous malformation symptoms
AVM symptoms can develop at any age, but they are most often noticed in a person’s 20s or later. Because AVMs cause gradual damage over time, symptoms tend to appear as people get older. If no symptoms have developed by the late 40s or early 50s, the AVM is usually stable and less likely to cause problems. In some cases, pregnancy can trigger new or worsening symptoms due to increased blood volume and blood pressure.
The first signs of an arteriovenous malformation often show up after bleeding occurs. Along with bleeding, symptoms may include:
- Difficulty thinking or concentrating, which can get worse over time
- Headaches
- Feeling nauseous or vomiting
- Seizures
- Fainting
Other symptoms that may happen include:
- Weakness in the muscles, especially in the legs
- Paralysis, or the loss of movement and feeling in one part of the body
- Trouble with coordination, which can make walking difficult
- Difficulty with tasks that need planning or organization
- Back pain
- Dizziness or feeling off balance
- Vision problems, like losing part of your sight, trouble moving your eyes or swelling in the optic nerve
- Difficulty speaking or understanding language (aphasia)
- Numbness, tingling or sudden pain
- Memory problems or confusion
- Seeing or hearing things that aren't there (hallucinations)
When to see a doctor
If you experience any severe symptoms or if they come on suddenly, don't wait—call 911 or go to the emergency room right away. Symptoms like an intense headache, suddenly passing out or losing the ability to move can be signs of a serious problem, like bleeding in the brain, which could be caused by an AVM or other conditions.
Even if you do not have these symptoms, it's a good idea to talk to your healthcare provider if you have risk factors for AVMs or if there's a history of neurological conditions in your family. Catching an AVM early and staying on top of your health can help prevent complications and guide the right treatment.
Arteriovenous malformation causes
The exact cause of AVMs is not fully understood. Most of the time, AVMs are congenital, meaning a person is born with them, but they can also develop shortly after birth or later in life. While AVMs can sometimes run in families, it's more common for other inherited conditions to increase the risk of developing an AVM.
Complications of AVMs
AVMs can lead to a range of complications, some of which can be life-threatening. These include:
- Bleeding: The biggest danger is when an AVM ruptures and causes bleeding in the brain. If an AVM in the brain ruptures, the bleeding can cause sudden neurological problems, such as weakness, numbness, trouble speaking or vision loss. Depending on the size and location of the bleed, it may cause permanent brain injury or, in severe cases, be life-threatening.
- Stroke: Even without rupture, AVMs can reduce or block normal blood flow to brain tissue. This can deprive part of the brain of oxygen, causing symptoms of stroke, such as difficulty with movement, speech or thinking.
- Aneurysm: A bulge in the wall of a weakened blood vessel, which can increase the risk of a dangerous rupture.
- Seizures: AVMs can irritate nearby brain tissue, leading to seizures. These seizures are caused by abnormal electrical activity in the brain that disrupts communication between brain cells and can range from brief staring spells to convulsions.
- Progressive neurological problems: In some cases, AVMs cause long-term pressure or damage to the brain without rupturing. This may lead to chronic headaches, difficulty with memory or concentration and gradual loss of strength, sensation or coordination.
How to diagnose arteriovenous malformation
Your doctor may use several methods to diagnose an AVM, beginning with a review of your medical history and a physical exam. To confirm the diagnosis, your doctor may recommend imaging tests that can provide clear images of your blood vessels, organs, tissues and any signs of vascular issues or bleeding.
Arteriovenous malformation treatment
Your doctor will develop a personalized treatment plan based on factors that are unique to you, including the type of AVM you have, the risk of it rupturing, the severity of your symptoms, your age, and your overall health. Treatment options may include medications to help manage symptoms or a procedure to remove or shrink the tangle of blood vessels.
The main goal of treatment is to prevent a rupture or eliminate the AVM entirely. Early treatment can help protect you from serious complications. Some people may only need occasional imaging tests to monitor the AVM and adjust medications as needed. Not everyone with an AVM needs surgery, and in some cases, surgery may be riskier than leaving the AVM in place.
Find specialized AVM care near you
At Baylor Scott & White, we offer specialized care and treatment for arteriovenous malformations at multiple locations across North and Central Texas. With our expert neurology centers, you can receive care from a team dedicated to your health and well-being. Whether you're seeking diagnosis, treatment or ongoing management, we are here to provide the support you need.
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