Treatment:

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.

Treatments include open brain surgery, endovascular treatment, and radiosurgery. Some treatment options are used together.

Open brain surgery is removes the malformation through an opening made in the skull. It must be done by a highly skilled vascular neurosurgeon. Possible complications include brain swelling, hemorrhage, stroke, or seizure.

Embolization (endovascular treatment) is the injection of a glue-like substance into the abnormal vessels to stop bleeding into the AVM. This may be an alternative if surgery can not be done.

Stereotactic radiosurgery is another alternative. This procedure delivers radiation directly to the area of the AVM. It is particularly useful for small deep AVMS which are difficult to remove by surgery.

Anti-convulsant medications, such as phenytoin, are usually prescribed if seizures occur.

Expectations (prognosis):

Approximately 10% of cases in which hemorrhage is the first symptom are deadly. Some patients may have permanent seizures and neurological problems.

Complications:

• Intracerebral hemorrhage
• Subarachnoid hemorrhage
• Seizures
• Permanent neurologic changes such as paralysis or sensory problems
• Focal weakness
• Numbness of any part of the face/body
• Vision changes
• Language difficulties
• Persistent headache
• Hydrocephalus (dilated cavities of the brain - "water on the brain")

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if you have a severe headache, vomiting, seizures, weakness or numbness of parts of the body, or other symptoms of a ruptured arteriovenous malformation.