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An AVM (arteriovenous malformation) is a tangle of arteries and veins. Normally, small vessels (capillaries) connect arteries and veins and deliver oxygen to the body’s tissues. In an AVM, arteries have abnormal connections directly to veins, which results in high-pressure blood flow to the AVM placing patients at risk for bleeding in the brain—a severe form of stroke.

This rare condition usually affects vessels in the brain or spine, but it can sometimes occur elsewhere in the body. An AVM can be fatal if it bursts and leaks blood into the brain. Barnes-Jewish Hospital treats the majority of AVMs in the St. Louis region, allowing us extensive experience in diagnosis and treatment.

Request a call to schedule an appointment with a Washington University neurosurgeon at Barnes-Jewish Hospital.

Diagnosis & Symptoms of AVMs

AVMs do not always cause symptoms, so they are often discovered during diagnosis or treatment of another condition. We use advanced imaging, including cerebral angiography, CT, CTA, MRI and MRA, to accurately diagnosis your AVM and create a treatment plan.

AVMs can cause many signs and symptoms. When symptoms are present, seizures and headaches are the most common. Other symptoms include:

  • Weakness or paralysis of arm, leg and/or face
  • Difficulty with speech or vision
  • Numbness or tingling sensations
  • Sudden onset headache or back pain
  • Loss of consciousness

If an AVM ruptures, it will bleed into the brain, which can cause brain damage or stroke. If you experience signs of stroke, such as sudden numbness or weakness on one side of your body or speech impairment, call 9-1-1 immediately for emergency treatment. 

Barnes-Jewish is one of 100 Comprehensive Stroke Centers in the United States, meaning we are equipped to treat the most severe strokes—including AVM rupture—at any time.

What Causes an AVM?

It’s uncertain why an AVM develops. Most people who have an AVM were born with the condition. There is uncertainty about whether or not AVMs are genetic. However, it is possible that families pass on a predisposition to having vascular malformations.

Treatment of AVMs

AVM treatment options depend on the type of AVM, its size and location (complexity), whether it has ruptured, and the overall health of the patient. Our team of neurosurgeons, diagnostic neuroradiologists, neurointerventional surgeons, neurointensivists, neuroanesthesiologists, neuro nurses are leaders in treating complex AVMs. We collaborate to determine the best course of treatment for each patient, prioritizing your safety. 

If there are few symptoms or the AVM’s location makes it difficult to treat, your doctor might recommend monitoring it, as well as keeping your blood pressure in a healthy range and avoiding blood thinners. 

Other treatment options may include:

  • Endovascular embolization uses a catheter to block blood vessels from supplying the AVM with blood. Doctors often use this before surgery to make removing the AVM safer.
  • Radiosurgery, or stereotactic radiosurgery, may be used for a smaller, unruptured AVM that would be difficult to remove surgically. It may also be combined with endovascular embolization for larger, complex AVMs. In this treatment, focused radiation damages the AVM to close the blood vessels and cure the AVM over time.
  • Surgery might be an option if the AVM is easy to reach or if it has ruptured. If your doctor believes the AVM is likely to bleed, it may be best to completely remove the abnormal blood vessels. 

Barnes-Jewish has an outstanding group of neurosurgeons and neurointerventional surgeons that are experienced in each treatment. We have full operating teams on site, so there is always an experienced neurovascular surgeon who can start your operation immediately in an emergency.

As an Academic Medical Center (AMC) and partner of Washington University School of Medicine, Barnes-Jewish has early access to the latest technologies and pioneers their use. You can also talk to your doctor about any of our available clinical trials.

To make an appointment with a Washington University neurosurgeon at Barnes-Jewish Hospital, call 888.994.2545.

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