An arteriovenous malformation (AVM) is abnormal, berry-like blood vessel patches in the brain. It's a congenital disease, meaning people are born with it.
UPMC is among the nation's largest, most experienced treatment centers for AVMs. Some treatments we use are microsurgical resection and Gamma Knife® radiosurgery.
An AVM is a group of blood vessels that have formed in an abnormal way.
The brain's arteries and veins connect in a way they shouldn't, creating a tangled mass of blood vessels. This changes the way blood flows in your brain.
An AVM is a condition you have from birth. You might not know that you have it because it doesn't always cause symptoms.
A large or growing AVM can put pressure on brain tissue and cause:
Because blood vessels form abnormally in an AVM, they're not as strong. These arteries and veins may weaken or burst. When this happens, blood leaks into the brain.
You may learn you have an AVM when you have an imaging test or during treatment for another health issue.
If doctors suspect you have an AVM, they may order tests such as:
UPMC neurosurgeons may do resection microsurgery when an AVM bursts or starts to bleed into the brain. They may also operate on an AVM that's at serious risk of bursting.
When blood leaks into the brain, it can cause permanent brain damage or stroke.
Your neurosurgeon will talk with you about your risk of AVM rupture.
Before suggesting AVM resection, they'll assess:
AVM surgery isn't right for everyone.
Your neurosurgeon will talk with you about the benefits and risks of AVM resection.
UPMC neurosurgeons may suggest surgery after looking at your imaging test results to make sure:
In some cases, doctors may recommend treatments like radiation to help shrink the AVM. Reducing the AVM's size can make it safer to remove the mass.
AVM surgery offers some important advantages.
It corrects the AVM right away and removes the risk of rupture and brain bleeding.
AVM resection involves delicately separating the AVM from the surrounding tissue.
Using a microscope, a UPMC neurosurgeon cuts off the blood supply to the AVM and removes it.
To prepare for AVM surgery, a member of your care team will:
Your neurosurgeon will first create an opening in your skull. A surgery that involves opening the skull is a craniotomy.
When the skull is open, the surgeon will:
You'll stay in a recovery room while you wake up from anesthesia.
Your care team will check your:
They'll also talk with you to check your brain function. They make sure you can speak, understand, and respond to commands. After the recovery period, you may move to the ICU where doctors will watch you closely.
The size and location of the AVM — and whether you experienced any brain bleeding — may affect your recovery after surgery.
During your hospital stay, someone from UPMC neurorehabilitation may visit you to see if you may benefit from:
As with any surgery, your body needs time to heal after AVM resection. You'll likely spend a few days in the hospital to make sure you're recovering as you should.
When you go home, it's vital to take things slowly at first.
During the first few weeks, it's normal to have:
Your neurosurgeon will talk with you about what to expect after surgery.
At first, you'll need to:
Talk to your doctor about when you can resume work or exercise. Follow their instructions and let them know if you have any new symptoms or don't feel well.
Your doctor may suggest other AVM treatments in addition to — or instead of — AVM resection.
These treatments include:
Surgeons thread a catheter through an artery in your groin to your brain. They inject a sticky substance through the catheter and into the AVM. This substance stops blood from flowing to the AVM and helps prevent bleeding.
This outpatient radiation treatment isn't really surgery. Doctors precisely target the AVM with focused radiation to shrink the mass. They may use this treatment when AVMs are in parts of the brain that make surgery too complex or impossible.
When you or someone you love has an AVM, we can connect you with others to help you cope.
Join us at an upcoming Aneurysm and AVM Support Group meeting.
UPMC neurosurgeons are experts in diagnosing and treating AVMs. We offer several treatment options to give you the best chance for a cure.
Contact the UPMC neurosurgery team to learn more about how we treat AVM or to make an appointment.
Or call us at 412-647-3685 or 1-877-320-8762 (outside the U.S.).
