In some people, an AVM can start to produce symptoms such as fits and headaches but it is not serious enough to justify brain surgery. This type of operation is very complex, and carries the risk that parts of the brain might be damaged by the treatment. An expert team of neurologists and neurosurgeons can balance the benefits of the surgery with these risks and advise each individual patient on their options.

Different drugs and medication can help with some symptoms:

  • Back pain and headaches can be treated with painkillers
  • Nausea that comes with headaches can be treated with anti-sickness medication
  • Fits and seizures can be controlled with anti-convulsants

None of these treatments will affect the size or severity of the AVM itself. If an AVM in the brain is in danger of causing a large bleed, various surgical treatments are available.

Surgery to remove an AVM

It is possible to remove an AVM from the brain using conventional brain surgery or to destroy it by stereotactic radiosurgery using a CyberKnife®:

  • Brain surgery involves opening a hole in the skull to gain access to the brain. The neurosurgeon then operates on the AVM using a microscope and microsurgical techniques to seal off the blood vessels that lead to the malformation. The goal is to completely remove the AVM.
  • Surgery is followed by a brain angiogram to check that the blood flow through the brain is stable, and that the AVM has been removed.
  • CyberKnife® treatment is very useful for treating small AVMs, making major brain surgery unnecessary. Highly focused radiation beams are targeted on the blood vessels of the AVM, causing them to close over the next few months to years.

Endovascular embolisation can seal off an AVM

Another technique that can be used for large AVMs that are difficult to access by surgery involves treating the AVM through the blood vessel system.

A catheter is placed into an artery in the groin area and passed to the AVM in the brain. Its journey is guided by imaging techniques. By injecting substances that block off the artery that leads to the AVM, the neurosurgeon may be able to shrink the AVM, reducing the risk that it will cause a significant bleed in the brain. As the AVM gets smaller, symptoms usually improve and the AVM may eventually become suitable for surgery to remove it completely.