What is an arteriovenous malformation?
An arteriovenous malformation (AVM) is a condition where a group of tangled, abnormal blood vessels affect how blood flows between your arteries and veins. AVMs are most commonly found in the brain and spinal cord, but can also occur in other parts of the body.
Normally, arteries carry oxygen-rich blood from the heart to the body's tissues, and veins return the blood back to the heart and lungs. Tiny blood vessels called capillaries help with this process by slowing blood flow and allowing oxygen to reach nearby tissues. But in an AVM, the capillaries are missing, so blood moves too quickly from arteries to veins without delivering oxygen where it's needed. This can lead to tissue damage and, over time, may cause the AVM to grow larger.
Many people with an AVM in the brain or spinal cord don’t have noticeable symptoms. However, in some cases, the abnormal blood vessels can weaken and rupture, causing bleeding in the brain (a hemorrhage), which can lead to a stroke or other serious complications. AVMs are often found by chance during tests for other health conditions.
Arteriovenous malformation symptoms
AVM symptoms can develop at any age, but they are most often noticed in a person’s 20s or later. Because AVMs cause gradual damage over time, symptoms tend to appear as people get older. If no symptoms have developed by the late 40s or early 50s, the AVM is usually stable and less likely to cause problems. In some cases, pregnancy can trigger new or worsening symptoms due to increased blood volume and blood pressure.
The first signs of an arteriovenous malformation often show up after bleeding occurs. Along with bleeding, symptoms may include:
- Difficulty thinking or concentrating, which can get worse over time
- Headaches
- Feeling nauseous or vomiting
- Seizures
- Fainting
Other symptoms that may happen include:
- Weakness in the muscles, especially in the legs
- Paralysis, or the loss of movement and feeling in one part of the body
- Trouble with coordination, which can make walking difficult
- Difficulty with tasks that need planning or organization
- Back pain
- Dizziness or feeling off balance
- Vision problems, like losing part of your sight, trouble moving your eyes or swelling in the optic nerve
- Difficulty speaking or understanding language (aphasia)
- Numbness, tingling or sudden pain
- Memory problems or confusion
- Seeing or hearing things that aren't there (hallucinations)
When to see a doctor
If you experience any severe symptoms or if they come on suddenly, don't wait—call 911 or go to the emergency room right away. Symptoms like an intense headache, suddenly passing out or losing the ability to move can be signs of a serious problem, like bleeding in the brain, which could be caused by an AVM or other conditions.
Even if you do not have these symptoms, it's a good idea to talk to your healthcare provider if you have risk factors for AVMs or if there's a history of neurological conditions in your family. Catching an AVM early and staying on top of your health can help prevent complications and guide the right treatment.
Arteriovenous malformation causes
The exact cause of AVMs is not fully understood. Most of the time, AVMs are congenital, meaning a person is born with them, but they can also develop shortly after birth or later in life. While AVMs can sometimes run in families, it's more common for other inherited conditions to increase the risk of developing an AVM.
Complications of AVMs
AVMs can lead to a range of complications, some of which can be life-threatening. These include:
- Bleeding: The biggest danger is when an AVM ruptures and causes bleeding in the brain. If an AVM in the brain ruptures, the bleeding can cause sudden neurological problems, such as weakness, numbness, trouble speaking or vision loss. Depending on the size and location of the bleed, it may cause permanent brain injury or, in severe cases, be life-threatening.
- Stroke: Even without rupture, AVMs can reduce or block normal blood flow to brain tissue. This can deprive part of the brain of oxygen, causing symptoms of stroke, such as difficulty with movement, speech or thinking.
- Aneurysm: A bulge in the wall of a weakened blood vessel, which can increase the risk of a dangerous rupture.
- Seizures: AVMs can irritate nearby brain tissue, leading to seizures. These seizures are caused by abnormal electrical activity in the brain that disrupts communication between brain cells and can range from brief staring spells to convulsions.
- Progressive neurological problems: In some cases, AVMs cause long-term pressure or damage to the brain without rupturing. This may lead to chronic headaches, difficulty with memory or concentration and gradual loss of strength, sensation or coordination.
How to diagnose arteriovenous malformation
Your doctor may use several methods to diagnose an AVM, beginning with a review of your medical history and a physical exam. To confirm the diagnosis, your doctor may recommend imaging tests that can provide clear images of your blood vessels, organs, tissues and any signs of vascular issues or bleeding.
Medical history and exam
Your doctor will start by asking about your medical history, especially any inherited conditions that could raise your risk of an AVM. They’ll also want to know about the symptoms you’ve experienced—when they started, how often they occurred and how they felt.
During the physical exam, your doctor will check your overall health. They may use a stethoscope to listen for a sound in your blood vessels called a "bruit." A bruit is a whooshing sound that can occur when blood flows through arteries and veins more quickly than usual, which may happen in people with an AVM.
Imaging tests
Several imaging tests can help your doctor understand the structure and function of your blood vessels and confirm the presence of an AVM. These tests include:
- Cerebral angiography: This X-ray-based test involves injecting a contrast agent (dye) into an artery, which allows your blood vessels to show up clearly in the images. It provides detailed pictures of the AVM.
- Computed tomography (CT) scan: A CT scan uses X-rays to create 3D images and can help detect a brain or spinal cord bleed.
- Magnetic resonance imaging (MRI) scan: An MRI creates detailed images of the blood vessel defect and the surrounding organs and tissues.
- Magnetic resonance angiography (MRA) scan: This type of MRI focuses on blood flow and can show how well blood is moving through a vascular defect. A contrast dye may be used, but it’s not always necessary.
- Transcranial Doppler ultrasound: This test sends sound waves through your skull to produce images of the arteries. Doctors can use these images to identify blood vessel defects.
Arteriovenous malformation treatment
Your doctor will develop a personalized treatment plan based on factors that are unique to you, including the type of AVM you have, the risk of it rupturing, the severity of your symptoms, your age, and your overall health. Treatment options may include medications to help manage symptoms or a procedure to remove or shrink the tangle of blood vessels.
The main goal of treatment is to prevent a rupture or eliminate the AVM entirely. Early treatment can help protect you from serious complications. Some people may only need occasional imaging tests to monitor the AVM and adjust medications as needed. Not everyone with an AVM needs surgery, and in some cases, surgery may be riskier than leaving the AVM in place.
Medication
While medications can't remove an AVM, they can help you manage symptoms and improve your quality of life. Your doctor may prescribe medications such as:
- Anti-seizure medications: These are for people who experience seizures, which can be a common symptom of AVMs. By controlling seizures, these medications help ensure your safety and allow you to continue participating in daily activities.
- Blood pressure medications: High blood pressure can increase the risk of an AVM rupturing. Medications that lower blood pressure can help reduce this risk, supporting better vascular health and preventing complications.
- Pain relievers: If you experience pain due to the AVM, such as headaches or discomfort, your doctor may recommend over-the-counter or prescription pain medications to provide relief and improve your overall comfort.
Surgery
Your doctor may recommend surgery if the AVM is growing, at risk of rupturing, or in a position where it would be easy to remove without significant risk of complications. Surgical options include:
- AVM resection: This procedure involves removing the AVM through a small incision. To prevent bleeding during the procedure, nearby blood vessels are closed off. Once the AVM is removed, the surgeon reroutes blood flow through healthy arteries and veins. This approach can be highly effective for AVMs that are easily accessible and not too deeply embedded in the brain or spinal cord.
- Embolization: A surgeon will inject coils or a glue-like substance into the AVM. This material blocks blood flow to the group of tangled blood vessels, which causes the AVM to shrink over time. This approach is often used in combination with surgery to shrink the AVM before removal, making the surgery less complicated and safer.
- Radiosurgery: This treatment is often used for small AVMs that are hard to reach with traditional surgery. It uses focused radiation beams to precisely target the AVM. The radiation damages the blood vessels in the AVM, causing them to shrink and eventually close off. This process happens gradually, with the AVM shrinking over a period of months or even years. Since it’s noninvasive, radiosurgery can be an effective option for treating AVMs that are difficult to remove through surgery.
Find specialized AVM care near you
At Baylor Scott & White, we offer specialized care and treatment for arteriovenous malformations at multiple locations across North and Central Texas. With our expert neurology centers, you can receive care from a team dedicated to your health and well-being. Whether you're seeking diagnosis, treatment or ongoing management, we are here to provide the support you need.
AccentCare - Fort Worth
3880 Hulen St , Fort Worth, TX, 76107
AccentCare Home Health of Brenham
526 W Main St , Brenham, TX, 77833
AccentCare Home Health of College Station
119 Medical Park Lane Ste C, Huntsville, TX, 77340
AccentCare Home Health of College Station
1605 Rock Prairie Rd Ste 206, College Station, TX, 77845
AccentCare Home Health Of Denton
225 W. Mulberry St. Ste A, Denton, TX, 76201
AccentCare Home Health Of Desoto
911 York Drive Ste 203, DeSoto, TX, 75115
AccentCare Home Health Of Fort Worth (Arlington)
700 Highlander Blvd Ste 205, Arlington, TX, 76015
AccentCare Home Health of Huntsville
122 Medical Park Lane B , Huntsville, TX, 77340
AccentCare Home Health of Marble Falls
1100 Mission Hills Dr Ste 100, Marble Falls, TX, 78654
AccentCare Home Health Of McKinney
6800 Weiskopf Ave Ste 100, McKinney, TX, 75070
AccentCare Home Health Of Taylor (Hutto)
567 Chris Kelley Blvd Ste 201, Hutto, TX, 78634
AccentCare Home Health Of Temple
3809 S General Bruce Dr Ste 105B, Temple, TX, 76502
AccentCare Home Health Of Waco
8300 Central Park Dr Ste A, Waco, TX, 76712
AdventHealth Central Texas
2201 S Clear Creek Rd , Killeen, TX, 76549
Andrews Women's Hospital at Baylor Scott & White - Fort Worth
1400 8th Ave , Fort Worth, TX, 76104
Baylor Scott & White - Hillcrest Infectious Disease Clinic
50 Hillcrest Medical Blvd MOB1, Ste 104, Waco, TX, 76712
Baylor Scott & White - Plano Brain and Spine Center
4708 Alliance Blvd Pavilion I, Ste 810, Plano, TX, 75093
Baylor Scott & White - Texas Brain and Spine Institute
900 Scott and White Dr , College Station, TX, 77845
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White - Texas Brain and Spine Institute - Huntsville
122 Medical Park Ln Ste A, Huntsville, TX, 77340
Baylor Scott & White - The Brenham Clinic
600 N Park St , Brenham, TX, 77833
- Monday: 7:30 am - 5:00 pm
- Tuesday: 7:30 am - 5:00 pm
- Wednesday: 7:30 am - 5:00 pm
- Thursday: 7:30 am - 5:00 pm
- Friday: 7:30 am - 5:00 pm
Baylor Scott & White 65+ Clinic
4716 Alliance Blvd Ste 500, Plano, TX, 75093
- Monday: 8:00 am - 4:30 pm
- Tuesday: 8:00 am - 4:30 pm
- Wednesday: 8:00 am - 4:30 pm
- Thursday: 8:00 am - 4:30 pm
- Friday: 8:00 am - 4:30 pm
Baylor Scott & White Advanced Cardiac Imaging Specialists
1100 Allied Dr , Plano, TX, 75093
Baylor Scott & White Advanced Cardiovascular and Imaging Consultants
4708 Alliance Blvd Ste 450, Plano, TX, 75093
Baylor Scott & White Advanced Digestive Care
3434 Swiss Ave Ste 200, Dallas, TX, 75204
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Advanced Heart and Lung Disease Center - Fort Worth
1420 8th Ave Ste 103, Fort Worth, TX, 76104
Baylor Scott & White Advanced Heart Care - Anna
450 N Standridge Blvd , Anna, TX, 75409
Baylor Scott & White Advanced Heart Care - Decatur
2401 S FM 51 Ste 200, Decatur, TX, 76234
Baylor Scott & White Advanced Heart Care - Denton
3333 Colorado Blvd , Denton, TX, 76210
Baylor Scott & White Advanced Heart Care - Idabel, OK
4 SE Avenue A , Idabel, OK, 74745
Baylor Scott & White Advanced Heart Care - Keller (Satellite)
3124 N Tarrant Pkwy Ste 204, Keller, TX, 76177
Baylor Scott & White Advanced Heart Care - McKinney (Satellite)
5236 W University Dr Ste 4450, McKinney, TX, 75071
Baylor Scott & White Advanced Heart Care - Mt Pleasant (Satellite)
1011 N Jefferson Ave , Mt Pleasant, TX, 75455
Baylor Scott & White Advanced Heart Care - Paris
875 S Collegiate Dr , Paris, TX, 75462
Baylor Scott & White Advanced Heart Care - Plano
4716 Dexter Dr Ste 100, Plano, TX, 75093
Baylor Scott & White Advanced Heart Care - Sherman Sycamore (Satellite)
203 E Sycamore St , Sherman, TX, 75090
Baylor Scott & White Advanced Heart Care - Sulphur Springs
601 Airport Rd Ste 110, Sulphur Springs, TX, 75482
Baylor Scott & White Advanced Heart Care – Sherman Highland (Satellite)
300 N Highland Ave , Sherman, TX, 75092
Baylor Scott & White Advanced Heart Failure Clinic - Irving
2001 N MacArthur Blvd Bldg 1, Ste 360, Irving, TX, 75061
Baylor Scott & White Advanced Heart Failure Clinic - Abilene
1219 E South 11th St Ste B2, Abilene, TX, 79602
Baylor Scott & White Advanced Heart Failure Clinic - Amarillo
1901 Medi Park Dr Ste 2051, Amarillo, TX, 79106
Baylor Scott & White Advanced Heart Failure Clinic - Dallas
3410 Worth St Ste 250, Dallas, TX, 75246
- Monday: 8:00 am - 4:30 pm
- Tuesday: 8:00 am - 4:30 pm
- Wednesday: 8:00 am - 4:30 pm
- Thursday: 8:00 am - 4:30 pm
- Friday: 8:00 am - 4:30 pm
Baylor Scott & White Advanced Heart Failure Clinic - Longview
906 Judson Rd , Longview, TX, 75601
Baylor Scott & White Advanced Heart Failure Clinic - Lubbock
3711 22nd St Ste B, Lubbock, TX, 79410
Baylor Scott & White Advanced Heart Failure Clinic - Midland/Odessa
420 E 6th St Ste 102, Odessa, TX, 79761
Baylor Scott & White Advanced Heart Failure Clinic - Tyler
1321 S Beckham Ave , Tyler, TX, 75701
Baylor Scott & White Advanced Heart Failure Clinic - Waxahachie
2360 N Interstate 35E MOB 2, Ste 310, Waxahachie, TX, 75165
Baylor Scott & White Advanced Heart Failure Specialists - Fort Worth
1250 8th Ave Ste 200, Fort Worth, TX, 76104
- Monday: 8:00 am - 5:00 pm
- Tuesday: 8:00 am - 5:00 pm
- Wednesday: 8:00 am - 5:00 pm
- Thursday: 8:00 am - 5:00 pm
- Friday: 8:00 am - 5:00 pm
Baylor Scott & White Advanced Lung Disease Specialists - Dallas
3410 Worth St Ste 250, Dallas, TX, 75246
- Monday: 8:30 am - 5:00 pm
- Tuesday: 8:30 am - 5:00 pm
- Wednesday: 8:30 am - 5:00 pm
- Thursday: 8:30 am - 5:00 pm
- Friday: 8:30 am - 4:30 pm
Baylor Scott & White All Saints Medical Center - Fort Worth
1400 8th Ave , Fort Worth, TX, 76104
Baylor Scott & White Ambulatory Endoscopy Center
4708 Alliance Blvd Pavilion I, Ste 210, Plano, TX, 75093
- Monday: 7:00 am - 3:00 pm
- Tuesday: 7:00 am - 3:00 pm
- Wednesday: 7:00 am - 3:00 pm
- Thursday: 7:00 am - 3:00 pm
- Friday: 7:00 am - 3:00 pm
Frequently asked questions
-
Is arteriovenous malformation hereditary?
Arteriovenous malformations (AVMs) are usually present at birth, but they aren't typically passed down through families. While AVMs themselves aren't hereditary, certain genetic conditions can make it more likely for someone to develop an AVM. If there’s a family history of these conditions, you might be at a higher risk.
-
Is arteriovenous malformation curable?
Yes, AVMs can often be treated successfully. Treatment options include surgery, embolization (for AVMs that are hard to reach), and radiosurgery (for larger AVMs). The right option depends on the AVM’s size and location. Some people may need follow-up treatments or regular check-ups to ensure the best results.
-
Can arteriovenous malformation cause stroke?
Yes, arteriovenous malformations (AVMs) can cause strokes. If an AVM ruptures, it can lead to bleeding in the brain (hemorrhagic stroke). AVMs can also block blood flow, causing a stroke from lack of oxygen (ischemic stroke). The risk depends on factors like size, location and age.