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What are arteriovenous malformations (AVMs) of the head and neck?

Arteriovenous malformations (AVMs) of the head and neck are defects of the blood vessels. Blood vessels present themselves as a tangled mass of arteries and veins. AVMs lack the capillary bed that normally exists in the common area where the arteries and veins lie in close proximity. AVMs can occur anywhere in the body and have been found in the arms, hands, legs, feet, lungs, heart, liver and kidneys. Half of all AVMs are located in the brain, brain stem and spinal cord. Because of the possibility of a hemorrhage, AVMs carry the risk of stroke, paralysis and the loss of speech, memory or vision. AVMs that hemorrhage can be fatal.

Symptoms

Most people diagnosed with brain or spinal cerebral arteriovenous malformations have few major symptoms, if any. The first symptom in about 50 percent of the people who are diagnosed with cerebral arteriovenous malformations is a stroke caused by bleeding in the brain.

Symptoms of a cerebral arteriovenous malformation that is bleeding:

  • Confusion
  • Ear noise/buzzing (also called pulsatile tinnitus)
  • Headache in one or more parts of the head that may seem like a migraine
  • Problems walking
  • Seizures

Symptoms of a cerebral arteriovenous malformation that is putting pressure on one area of the brain:

  • Dizziness
  • Muscle weakness in an area of the body or face
  • Numbness in an area of the body
  • Vision problems

Risk factors

The cause of AVMs of the head and neck are unknown. However, most develop during fetal development, and there are certain risk factors that include:

  • Gender (AVMs happen more frequently in males)
  • Family history (there may be a genetic factor in vascular malformations, including AVMs)

How is it diagnosed?

Our specialists provide thorough neurological evaluations, including diagnosis of arteriovenous malformations, using the latest diagnostic technology, including CT angiography and 3D angiography.

Types of treatment

Our multidisciplinary team is experts at several treatment options for AVMs. Your care team will determine the best treatment based on several factors. Potential treatments include:

  • Lifestyle changes—If you have few or no symptoms or if your AVM is in a location that isn’t easily treated, conservative medical treatment may be recommended. This may include avoiding activities that elevate blood pressure and avoiding blood thinners.
  • Surgery—In some cases, surgical removal is the best option to completely remove the AVM. This prevents the chance of future bleeding.
  • Stereotactic radiosurgery—In relatively small AVMs, a cerebral angiogram is done to pinpoint the AVM. Focused beam high energy is used to damage blood vessels to cause them to scar and clot the AVM.
  • Interventional neuroradiology—A small catheter is placed inside the blood vessel that supplies the AVM to block the flow of blood. Liquid tissue adhesives, micro coils, particles and other materials can be placed through the catheter to stop blood flowing to the AVM.
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