Arteriovenous Malformations of the Brain Symptoms & Diagnosis

Symptoms

There are a number of symptoms that you may experience if you have an arteriovenous malformation. Symptoms vary from person to person. They also depend on the location of the arteriovenous malformation in your body.

If you experience any of these symptoms, do not assume it is due to arteriovenous malformations. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your physician.

• Intracranial hemorrhage—bleeding within the skull
  • This is the most common symptom, affecting approximately half of those with arteriovenous malformations.
• Seizure—occurs in 20%-25% of all cases
• Headache
  • Headaches are a common symptom, affecting approximately 15% of cases. Sometimes headaches linked to one side of the head may be a sign that an arteriovenous malformation is there.
• Muscle weakness
• Paralysis (loss of movement) on one side of the body
• Dizziness
• Inability to perform purposeful movements but not due to paralysis (also known as apraxia)
• Loss of coordination, especially when walking (also known as ataxia)
• Abnormal blood flow sound
  • This sound, also called a bruit, can be identified by your doctor by using a stethoscope. It is caused by the extremely fast flow of blood through arteries and veins of an arteriovenous malformation.
• Sudden, severe back pain
• Difficulty speaking or understanding language
• Loss of sensations (hearing, taste, or touch)
• Visual disturbances
• Memory loss
• Difficulty thinking or mental confusion
• Hallucinations
• Dementia

Children under the age of two may have different symptoms, including:

• Congestive heart failure (inability of the heart to pump out all the blood that returns to it)
• Hydrocephalus (excessive build-up of fluid within the brain—gives the appearance of a large head)
• Seizures

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam.

Your doctor will need more information to make an evaluation. To get a more comprehensive understanding of your condition, your doctor may order some tests. Tests may include the following:

• Angiography or arteriography —dye (also called a contrast agent) is injected into your arteries and x-rays are taken to determine blood circulation.
• Superselective angiography—a catheter, which is a very thin, flexible tube, is inserted into your artery until it reaches the site of the arteriovenous malformation. Your physician will then release a small amount of a dye (contrast agent) directly into the lesion. Then x-rays are taken to examine blood flow at the lesion site.
• Computed axial tomography (CT scan or CAT scan) —a computer takes information from multiple x-rays taken of your head, brain, and/or spinal cord. This is often used to determine and locate hemorrhages.
• Magnetic resonance imaging (MRI) —Using magnets and radio waves, your doctor obtains images of your brain and spinal cord. MRIs are very sensitive and can show if hemorrhaging has occurred. It can also provide information about the location and physical features of the arteriovenous malformation.
• Magnetic resonance angiogram (MRA) —This test involves the injection of a contrast dye into your arteries, after which images are obtained through the use of an MRI machine.

Your doctor will most likely refer you to a specialist for further examination and treatment. There are a number of specialists who focus on arteriovenous malformation, including neurologists, neurosurgeons, and neuroradiologists.