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
• Radiosurgery

Some treatment options are used together.

Open brain surgery removes the malformation through an opening made in the skull. It must be done by a highly skilled neurosurgeon.

Embolization (endovascular treatment) is the injection of a glue-like substance 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 radiation directly to the area of the AVM to cause scarring and shrinkinge. It can control bleeding and other symptoms. 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:

• Focal weakness
• Intracerebral hemorrhage
• Language difficulties
• Numbness of any part of the face or body
• Permanent neurologic changes such as paralysis or sensory problems
• Persistent headache
• Seizures
• Subarachnoid hemorrhage
• Vision changes
• Water on the brain (hydrocephalus)

Possible complications of open brain surgery include:

• Brain swelling
• Hemorrhage
• Seizure
• Stroke

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if you have:

• Numbness in parts of the body
• Seizures
• Severe headache
• Vomiting
• Weakness
• Other symptoms of a ruptured arteriovenous malformation

Also seek medical attention if you have a first ever seizure, because AVM is occasionally the cause of seizures.