Finding the best treatment for an AVM that is found on an x-ray or other imaging tests but is not causing any symptoms can be difficult. Your doctor will discuss with you:
- The risk that your AVM will break open (rupture). If this happens, there may be permanent brain damage.
- The risk of any brain damage if you have one of the surgical treatments listed below.
Your doctor may discuss different factors that may increase your risk of bleeding, including:
- Current or planned pregnancies
- What the AVM looks like on imaging tests
- Size of the AVM
- Your age
- Your symptoms
A bleeding AVM is a medical emergency. The goal of treatment is to prevent further complications by controlling bleeding and seizures and, if possible, removing the AVM.
Three surgical treatments are available. Some treatments are used together.
Open brain surgery -- removes the abnormal connection through an opening made in the skull. It must be done by a highly skilled surgeon.
Embolization (endovascular treatment):
- A catheter is guided through a small cut in your groin to an artery and then to the small blood vessels in your brain where the aneurysm is located.
- A glue-like substance is injected into the abnormal vessels to stop blood flow in the AVM and reduce the risk of bleeding. This may be the first choice for some kinds of AVMs, or if surgery cannot be done.
Stereotactic radiosurgery is another alternative.
- This procedure delivers very focused radiation directly to the area of the AVM to cause scarring and shrinkage.
- It is particularly useful for small AVMs deep in the brain, which are difficult to remove by surgery.
Anticonvulsant medications, such as phenytoin, are usually prescribed if seizures occur.