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Arteriovenous Malformation (AVM) - Treatment

There are a variety of accepted treatment techniques dependent on the size and location of the abnormal blood vessels.

Surgical Removal.
Many small brain AVMs are amenable to safe and effective surgical removal. A small section of the skull bone is removed temporarily to allow the surgeon to access the AVM. Using a high powered microscope, the surgeon then seals off the AVM with special clips and then removes it from the surrounding brain tissue. When the AVM has been successfully removed, the skull bone is reattached and the surgical would is closed.

Because AVMs do not grow back, the cure is immediate and permanent if the AVM is completely removed.

Surgical removal (surgical resection) is performed when the risk of hemorrhage or seizure is considered to be within acceptable parameters. AVMs that are deep within the brain inherently carry a higher risk of complication, and other treatments may be preferable.

Endovascular Emobilization
This procedure involves the insertion of a catheter into an artery in the leg. The catheter is a long, thin tube which is then threaded through the body’s circulatory system until it reaches the arteries of the brain. It is carefully positioned within the brain and then small amounts of a liquid, non-reactive glue are injected through the catheter into the blood vessels which form the AVM  and block off blood flow to the AVM.

This procedure is sometimes done alone, or before surgery to reduce the chance of bleeding during the operation. In some large AVMs, the procedure has been found to reduce the stroke-like symptoms.

Stereotactic Radiosurgery
Stereotactic radiosurgery utilizes computer guided and focused radiation to destroy the AVM. The narrowly focused radiation causes the blood vessels involved in the AVM to shrivel up and clot in the months or years following the procedure. Stereotactic radiosurgery is best suited to small AVMs that have not previously caused a dangerous hemorrhage. Until the AVM is completely closed off, the risk of bleeding persists.

In nonemergency settings, AVMs can be evaluated and diagnosed by a Princeton Brain and Spine Care Physician.  If you would like an evaluation, call for an appointment at one of our 4 convenient locations.  If however you are in an urgent situation, we recommend the following facilities that can handle these types of problems in an emergency setting.

IN NEW JERSEY: Robert Wood Johnson University Hospital in New Brunswick or Morristown Memorial Hospital in Morristown.
IN PENNSYLVANIA: St. Mary Medical Center in Langhorne and University of Pennsylvania in Philadelphia.  

Experts in this area of neurosurgery include:
IN NEW JERSEY: Dr. Gaurav Gupta, Director of Cerebrovascular Neurosurgery at Robert Wood John University Hospital
IN PENNSYLVANIA: Dr . Michelle Smith, Director of Cerebrovascular Neurosurgery at University of Pennsylvania.


LastUpdate: 2016-05-11 17:25:00


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