What Is Intracranial Arteriovenous Malformation?

Arteriovenous malformations are a group of abnormally developed pathological cerebrovascular vessels that drain directly to the vein without passing through the capillary bed, forming a short circuit between arteriovenous veins, which are mostly supplied by one or more arteries, and the drainage vein can also be one or several Branches can cause hemodynamic disorders. Intracranial arteriovenous malformation refers to this disease that occurs in the skull. According to the location of the disease, it is divided into cerebral arteriovenous malformations, dural arteriovenous malformations, and meningeal arteriovenous malformations.

Arteriovenous malformations are a group of abnormally developed pathological cerebrovascular vessels that drain directly to the vein without passing through the capillary bed, forming a short circuit between arteriovenous veins, which are mostly supplied by one or more arteries, and the drainage vein can also be one or several Branches can cause hemodynamic disorders. Intracranial arteriovenous malformation refers to this disease that occurs in the skull. According to the location of the disease, it is divided into cerebral arteriovenous malformations, dural arteriovenous malformations, and meningeal arteriovenous malformations.

English name

Intracranial Arteriovenous Malformations

Visiting department

Department of Neurology, Cardiology

Multiple groups

30-50 years old

Common locations

Cerebrovascular

Common causes

Congenital cerebrovascular abnormality

Common symptoms

Intracranial hemorrhage, headache, seizures, loss of nerve function,

Causes of intracranial arteriovenous malformations

If there are some factors during the embryonic period that affect the normal development of the original cerebrovascular network, the capillaries are not sound, and the arteries and veins are directly connected to form a short circuit, which can develop into cerebral arteriovenous malformations.

Clinical manifestations of intracranial arteriovenous malformations

Intracranial hemorrhage

Small bleeding, more symptoms are not obvious. Large amounts of bleeding can cause headaches, vomiting, disturbances of consciousness, and even brain hernias, leading to the termination of life.

Seizures

The younger the age, the higher the chance of epilepsy, mostly due to arteriovenous malformations in the frontal and temporal lobes. Some patients show a major attack, while others show a focal attack. Prolonged seizures can cause patients with mental retardation.

3. headache

Almost half of the patients have a history of chronic headache, with unilateral local or total headaches, intermittent or persistent attacks, and some patients have migraine headaches. Sudden bleeding can cause an acute headache.

4. Nerve function loss

Intracerebral hematoma caused by sudden bleeding can cause acute hemiplegia, blindness, sensory disturbances, and aphasia in patients. Some non-bleeding patients also cause progressive neurological deficits, such as motor, sensory, vision, visual field, language, memory, intelligence, and computing dysfunction.

5. Other symptoms

In some patients, intracranial hairy murmurs can occur, which are common in larger, superficial arteriovenous malformations. Arteriovenous malformations in infants and children can cause cardiac dysfunction.

Intracranial arteriovenous malformation

CT scan of the head

When bleeding, CT can determine the location and extent of bleeding, and some lesions can appear as mixed density areas.

2. Magnetic resonance imaging

Due to the air-flow phenomenon of high-speed blood flow in the lesion, the vascular group, the blood supply artery and the drainage vein are all black.

3. Whole brain arteriography

It is a necessary means for confirming the diagnosis. The gold standard for diagnosis can determine the position, size, scope, blood supply arteries, draining veins and blood flow velocity of the malformed blood vessel mass.

4. EEG examination

In patients with seizures, an EEG may be performed to confirm the extent of the epilepsy.

Diagnosis of intracranial arteriovenous malformations

The diagnosis is generally not difficult based on symptoms, signs, and imaging.

Treatment of intracranial arteriovenous malformations

Surgical removal

It is the most thorough method for treating intracranial arteriovenous malformations, which can eliminate the risk of bleeding from lesions, improve cerebral blood supply, and control seizures.

2. Radiation therapy

For patients with lesions less than 3 cm, located in important functional areas, or deep in the inability to operate, stereotactic radiotherapy can be selected, and gamma knife is often selected. However, it usually takes effect after 1 to 3 years, during which bleeding may occur.

3. Interventional embolization

Intravascular intervention can be used to embolize the supplying arteries. However, the total occlusion rate of arteriovenous malformations by interventional embolism alone is relatively low, and it is usually used as an auxiliary method before surgical resection and radiosurgery.

4. Comprehensive treatment

The above two methods, or a combination of two or more methods, can be used to combine the advantages of each method to cure the disease to the greatest extent possible.