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Arteriovenous Malformation (AVM)

Overview
Symptoms
Diagnosis
Treatment Options
Where to Seek Treatment
National Neuroscience Institute
Contributed by Dept of Neurosurgery

Overview

An Arteriovenous Malformation (AVM) is a congenital lesions which comprises an abnormal collection of blood vessels, where arterial blood flows directly into the draining veins without the normally intervening capillaries. AVMs appear as a "tangle" of blood vessels and most commonly occur in the brain or spinal cord.


Symptoms

Presenting symptoms include:

  • Bleeding - 50% of patients with AVMs will present with a hemorrhage
  • Seizures - 25% of patients have this as their presenting symptom
  • Pressure on the surrounding brain resulting in stroke like symptoms
  • Headaches
  • The risk of hemorrhage from an AVM is estimated to be about 2 to 4 percent per year.

Diagnosis

Arteriovenous Malformation can be diagnosed on a CT or MRI brain scan.

They may be diagnosed incidentally or after hemorrhage.

After detection of an AVM, further evaluation needs to be carried out by cerebral angiography. This will give further information regarding the structure of the AVM, the contributing and drainage vessels which will influence treatment decisions.

Cerebral Angiogram showing mass of tangled vessels

AVMs are graded by the Spetzler-Martin grading system. This is based on points allocated based on the size, location and pattern of blood flow of the AVM.

The grading ranges from 1 to 5. The higher the grading, the greater the difficulty of treatment.


Treatment Options

  • Conservative management and observation
  • Endovascular embolisation combined with Surgical Excision
  • Stereotactic radiosurgery

The factors involved in treatment include:

  • Age of patient
  • The current clinical condition of the patient
  • Risks of surgery
  • Morphology and location of the AVM


Where to Seek Treatment

The medical institutions within SingHealth that offer consultation and treatment for this condition include:

1. National Neuroscience Institute - Singapore General Hospital Campus
Dept of Neurosurgery
Outram Road, Singapore 169608

Appointments Hotline:
Tel : +65 6321 4377

International Enquiries, please contact:
Tel : +65 6326 5656
Email : ims@singhealth.com.sg
   
2. National Neuroscience Institute - Tan Tock Seng Hospital Campus
Dept of Neurosurgery
11 Jalan Tan Tock Seng, Singapore 308433

Appointments Hotline:
Tel : +65 6357 7095

International Enquiries, please contact:
Tel : +65 6326 5656
Email : ims@singhealth.com.sg





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