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It's important to get medical attention for an AVM as soon as possible. Often, immediate treatment may help avoid serious complications of some AVMs. Current surgical methods make treatment for AVM safer and more effective than ever. The goal of treatment is to stop the flow of blood within the AVM.
The members of your healthcare team guide you through your treatment, support you, and answer your questions. Your team may include the following specialists:
A neurosurgeon is a doctor who performs the procedure needed to correct your problem.
A radiologist is a doctor who specializes in the use of radiation in the diagnosis and treatment of disease.
Nurses provide patient care and may also teach family and friends to assist with your recovery.
Physical and occupational therapists help with walking, dressing, and other life skills.
Speech therapists focus on speech and swallowing problems.
A case manager or social worker helps guide you through the healthcare system.
Surgical resection removes the tangled blood vessels.
Reaching the brain: The surgeon uses a procedure called craniotomy to reach the brain. During a craniotomy, small holes called burr holes are made in the skull. The bone between the holes is cut and lifted away. Finally, the surgeon opens the dura and exposes the brain.
Removing the AVM: Once the surgeon has access to the AVM, the abnormal arteries and veins are removed. This redirects blood flow to normal vessels, preventing the AVM from bursting and leaking blood.
Closing the skull: When the AVM has been removed, the dura covering the brain is closed. In most cases, the skull bone is put back. The skull bone can be held in place using one of several methods. Titanium clamps are often used, as they provide the most stability and cover the burr holes. After the clamps are in place, the skin incision is closed with stitches or staples.
AVMs sometimes require a combination of treatments. Other treatments include:
Radiosurgery: Radiation (beams of light) can be directed at the AVM using a tool called a gamma knife. This closes off the abnormal blood vessels, so that blood no longer flows through them. A specialist may be involved.
Embolization: Glue is inserted into the AVM through a catheter (very thin tube). This breaks apart the AVM and holds the blood vessels in a new location. Embolization may occur in isolation or as part of the surgical procedure. A specialist may be involved in embolization.