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Spinal Arteriovenous Malformations

Spinal Arteriovenous Malformations

What is a spinal arteriovenous malformation?

Arteriovenous malformations (AVMs) occur when the connections between your veins and arteries don't form correctly and the vessels become entangled. Usually, these abnormalities develop in the fetus, or in a newborn baby.

AVMs can occur anywhere in the body. When they happen in the spinal cord and brain, they are called neurological AVMs, and are more likely to affect different parts of your body. This is because the brain and spinal cord make up the central nervous system. Neurological AVMs affect about 300,000 Americans. 

What causes spinal arteriovenous malformations?

AVMs are equally common among different races and ethnicities, and in both sexes. Most people don't even know that they have a spinal AVM—it may be found during treatment or diagnosis for another condition. Their size can vary from less than an inch, to 2.5 inches. Less than 15% of people with neurological AVMs will have symptoms or complications.

Spinal AVMs can cause problems with circulation because they interfere with your body's blood flow. Normally, your arteries transport oxygen-rich blood away from your heart and to cells throughout your body. Your veins carry that blood, with its oxygen stores used up, back to your lungs and heart. But the malformations of your arteries and veins in spinal AVMs don't allow this natural cycle to occur because of missing capillaries, which regulate blood flow.

Spinal AVMs can also lead to a serious situation if they rupture, causing bleeding into surrounding areas. They can also cause symptoms by compressing parts of your spinal cord. 

What are the symptoms of spinal arteriovenous malformations?

Spinal AVMs often don’t cause any symptoms. When they do, they're usually minor and difficult to notice. In a small number of people, however, the symptoms can be severe enough to affect their ability to function.

These are the most common symptoms of a spinal AVM:

  • Muscles that feel weak or become paralyzed
  • Ataxia, a condition in which you have problems with balance and coordination
  • Pain or unusual sensations throughout your body, such as tingling or numbness

How are spinal arteriovenous malformations diagnosed?

If you have symptoms, your health care provider may use these tests to find out if you have a spinal AVM:

  • Angiography (X-rays used along with a dye injected into your artery)
  • MRI scans
  • CT scans
  • Magnetic resonance angiography


How are spinal arteriovenous malformations treated?

Treatment may involve a combination of surgery by a neurosurgeon, or an endovascular embolization. This is less invasive than surgery. A radiologist (a doctor who reads X-rays) plugs your vessels with a catheter. Radiation therapy is also an option. The type of surgery you have depends on the location and size of your AVM. 

Your doctor may also give you medications to treat symptoms, such as back pain, caused by AVMs. 

What are the complications of spinal arteriovenous malformations?

If spinal AVMs aren't treated, they may cause damage to your spinal cord because it can't get the oxygen it needs from your blood. A spinal AVM may also hemorrhage and leak blood.

Living with spinal arteriovenous malformations

Even though a spinal AVM may not always cause symptoms, it can still be dangerous, particularly if it starts to cause symptoms. Your health care provider should check any suspicious symptoms you have. These may include:

  •  Muscles that feel weak
  •  Muscle paralysis
  •  Difficulty with balance and coordination (ataxis)
  •  Unusual sensations, such as numbness or tingling, or pain

Key points

  • Arteriovenous malformations (AVMs) occur when the connections between veins and arteries don't form correctly and the vessels become entangled. 
  • AVMs can occur anywhere in your body. But when they happen in the spinal cord and brain, called neurological AVMs, they are more likely to affect different parts of your body.
  • Pay attention to the following symptoms and seek medical help for:
    • Muscles that suddenly feel weak or become paralyzed
    • Any problems you may be having with balance and coordination
    • Pain or unusual sensations, such as numbness or tingling in your body
    • Headaches that won’t go away

Seizures or feeling unable to control your muscles

When should I call my health care provider?

Your doctor should evaluate any signs or symptoms that indicate a problem with your nervous system, such as headaches that won't go away, seizures, and difficulty controlling your muscles.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

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