Arteriovenous Malformations (AVM)
What is an AVM?
An Arteriovenous Malformation (AVM) is a medical condition characterized by an abnormal tangle of arterial and venous blood vessels. While AVMs can occur in various parts of the body, including the brain, spinal cord, and other organs, AVMs in children typically are formed in the brain.
What Might Cause an AVM in Children?
The exact cause of AVMs in children is not fully understood. AVMs are generally believed to be congenital, meaning they develop during fetal development or shortly after birth. However, the specific factors that contribute to their formation are not always clear. Some potential factors that might play a role in the development of AVMs include:
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Genetic Factors: There might be a genetic predisposition to AVMs, meaning that certain genes or genetic mutations could increase the likelihood of their occurrence.
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Abnormal Blood Vessel Development: During fetal development, errors in the formation and growth of blood vessels could lead to the development of AVMs.
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Environmental Influences: While not well-established, some environmental factors during pregnancy could potentially influence the development of AVMs, although this is still an area of research.
What Symptoms Might an AVM Cause in Children?
The symptoms of AVMs can vary widely depending on the location, size, and characteristics of the AVM. In the context of AVMs in the brain, the following symptoms might occur:
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Seizures: The most common presenting symptom, especially if the AVM is in the cerebral cortex.
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Headaches: Persistent, severe headaches can be a sign of an AVM, particularly if they are accompanied by other neurological symptoms.
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Neurological Deficits: These can include weakness, numbness, or tingling in a specific part of the body, difficulty speaking, impaired vision, or problems with coordination and balance.
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Bleeding: If an AVM ruptures and causes bleeding into the brain, it can cause sudden and severe symptoms, including a severe headache, nausea, vomiting, altered consciousness, and even loss of consciousness. This is a medical emergency and requires immediate attention.
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Cognitive Changes: Memory problems, confusion, difficulty concentrating, and other cognitive changes might be present if the AVM affects areas of the brain responsible for these functions.
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Behavioral Changes: Mood swings, personality changes, and emotional disturbances can occur if the AVM affects brain regions that regulate emotions and behavior.
What Treatments are Available for AVMs in Children?
Once your child’s has been diagnosed with an AVM, I (as a pediatric neurosurgeon in New York) will work with you, your child, and other medical professionals (e.g., pediatrics, and neurologist) at Children's Hospital at Montefiore (CHAM) to formulate a customized treatment strategy tailored to your child’s needs. This customized treatment may utilize any one or a combination of the following interventions:
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Surgical Removal: Surgical intervention involves removing the AVM through a procedure called surgical resection. This is a common approach if the AVM is accessible and its removal is feasible without causing significant damage to surrounding brain tissue.
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Embolization: This minimally invasive procedure involves inserting a catheter into the blood vessels leading to the AVM. Small particles or substances are then injected to block the blood flow, causing the AVM to shrink. Embolization may be used as a standalone treatment or as a precursor to surgery to make the procedure safer and more effective.
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Radiosurgery: Stereotactic radiosurgery, such as Gamma Knife or CyberKnife, uses precisely targeted high doses of radiation to shrink the AVM over time. It is a non-invasive option suitable for some cases where surgery may carry higher risks.