Updated: May 26, 2020
Arteriovenous Malformation (AVM) is an abnormal tangle of arteries and veins. AVM's usually occur in the brain or spine, and most of the time, people are completely unaware that they are present. A dural AVM is a special type of AVM which takes place in the brain. A dural AVM is among the rarest types and occurs in less than 1% of the general population. It is the most dangerous AVM because of the damage it can cause through bleeding.
While we still do not know the cause of AVM's, we know that a dural AVM can occur in adults following an injury. Most AVM's are congenital and not passed down genetically, unless a carrier has H.H.T, which is a disorder where blood vessels do not develop properly. The average age in which an AVM is discovered is around 20-40. An AVM doesn’t care who you are in terms of who it affects; across the board, every race and gender are typically equal in diagnosed rates.
When treating an AVM the main goal is to stop bleeding and prevent future bleeding. Treating an AVM should not be postponed and should not be taken lightly. The bleeding in a dural AVM can cause a stroke, resulting in possible permanent disabilities or death. If a child is discovered with an AVM their risk of bleeding is around 87% after 50 years. And the risk of bleeding amongst AVM carriers is around 4%.
The range of symptoms ranges from seizures due to an abundance of electrical activity; headaches can occur through a dural AVM because of the higher blood pressure. Dural AVM's can also produce stroke-like symptoms due to a lack of oxygen and nutrients getting to the brain. Stroke-like symptoms can include anything from weakness and paralysis to problems with hearing, vision, and memory, and in extreme cases, personality changes. The final symptom is of course, bleeding. Bleeding caused by a ruptured AVM or aneurysm is the main reason to seek treatment and can cause the most permanent damage. The average rate of acquiring a disability through bleeding is 50%, whether its a major bleed or even a minor one.
Treatment for an AVM can be either radiation treatment or brain surgery, depending on the location and complexity of the AVM. Radiation treatment is where a narrow x-ray beam is focused on the AVM, and a lower dose is focused on the rest of the brain. The goal with this procedure is to get the AVM to shrivel up in about two to three years, and the risk of bleeding is still present in those recovery years. With brain surgery, the patient is put under anesthesia and into an operating room. The risk of this procedure is much higher, and the results vary depending on whether the AVM has ruptured, causing the surgery, or if the surgery was proactive to remove the AVM before it ruptures.