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The Department of Neurosurgery at Brigham and Women’s Hospital provides compassionate, patient-centered diagnosis and comprehensive treatment of brain and spinal Arteriovenous Malformations (AVMs) through our AVM Program. Our experienced cerebrovascular neurosurgeons, neuro-interventional radiologists, and vascular neurologists collaborate with each other in an interdisciplinary approach to treatment to provide the best possible non-surgical and advanced surgical options for those with AVMs with the goal of providing the greatest lifestyle improvement for a better quality of life. As a teaching affiliate of Harvard Medical School, our neurosurgeons participate in cerebrovascular research and clinical trials, which are instrumental in perfecting and tracking treatments and protocols to improve the future of AVM treatment.
An arteriovenous malformation (AVM) is an abnormal connection between arteries and veins, resulting in a “tangle” of blood vessels in the brain and spinal canal. In normal circulation, blood flows from arteries to capillaries and then to veins, taking blood from high pressure to low pressure gradually. However, in AVMs, blood flows directly from arteries to veins through an abnormal passageway called a fistula, rather than through capillaries. This leads to downstream effects, including increased flow and pressure. Over time, the vessels fatigue, leading to rupture. The injury can endanger physical and neurological functions — such as sight, sensation, critical thinking and movement — that are associated with that area of the brain. A rupture also can be fatal.
Some brain AVMs come to attention in ways other than bleeding, such as seizure. The majority of patients are between 20 to 50 years of age when a brain AVM comes to be diagnosed. However, brain AVMs can affect people of any age.
View the wonderful story of patient Nicole Haight and curing her brain arteriovenous malformation (AVM) by Neurosurgeon Nirav J. Patel, MD, and his team at Brigham and Women's Hospital.
Nirav J. Patel, MD, Neurosurgeon at Brigham and Women’s Hospital, discusses the treatment and approach to care for an arteriovenous malformation (AVM) diagnosis.
This tangle of arteries and veins usually develops before birth or shortly after. Occasionally, an AVM forms later in life, though it is unclear if the risk for an AVM is passed down through families genetically. For someone with an AVM, an increase in blood pressure is a risk factor for rupture.
Most people who have an AVM may be unaware of the abnormality and experience no symptoms. Some brain AVMs present with symptoms including:
Women with AVMs can sometimes develop symptoms during pregnancy.
A team of specialists at Brigham and Women’s Hospital Center for Cerebrovascular Diseases (including neurosurgeons, endovascular surgeons, neurologists and radiation oncologists) collaborate to determine the best treatment for each AVM. The best treatment depends on the AVM’s location and anatomy and the decision is centered around the patient, to achieve a cure with the least risk.
Learn more about arteriovenous malformation treatment at Brigham and Women's Hospital.
The neurosurgeons at the Brigham and Women's Hospital Center for Cerebrovascular Diseases are skilled in advanced techniques for the repair of AVMs.
Our experienced neurosurgeons, vascular neurologists, and radiologists collaborate closely to determine the best course of treatment—including minimally invasive surgery—for each AVM patient. By applying advanced techniques and delivering comprehensive care, we can bring life-changing results to our patients.
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