November 26, 2017

Brain AVM

Brain AVM is a collection of abnormal blood vessels in the brain having blood flow at dangerously high speed

Brain AVM

A collection of abnormal blood vessels connecting the artery to the vein is what we call an AVM

So what makes these blood vessels abnormal ?

They are abnormal because they directly connect arteries to veins

An example to make us understand  : Road bumps are placed in streets to control the speed of cars

If you have certain streets without traffic lights or road bumps things can get messy and accidents can occur

Brain AVM

The capillaries act as a speed bump in the circulatory system

That’s the case in Brain AVMs, just arteries joined to veins, and no intervening capillaries to adjust the flow rate

Normally arteries pump blood to the brain, the oxygen in the blood is delivered to the brain cells by a network of capillaries, then the wastes in the blood is drained through the veins

This system works in perfect balance, and is responsible for adjusting the blood flow in the brain

In a brain AVM there is no capillaries between the arteries and veins, therefore an AVM has high blood flow rates with high pressure

Brain AVM

This causes stress on the vessels wall, that can blow up with time !

Symptoms of a Brain AVM

In a majority of people having a brain AVM they have no symptoms at all

Owing to the fast blood flow across the AVM some patients experience constant headaches

Others experience convulsions (epileptic fits) , and these can range from fits that rarely occur, to daily debilitating fits that impair with normal daily function, and moreover are resistant to antiepileptic drugs

The most serious condition that could result from having a brain AVM is that the high flow rate & blood pressure could lead to blowing up of the AVM leading to brain bleeding that is a very serious condition and could lead to coma or death

The risk of death after a brain bleed from an AVM ranges from 16 to 66%

And regarding the survivors, 40% suffer a permanent neurological disability

A person having a Brain AVM has an annual risk of AVM rupture about 3%

And if we rephrase it … 40 to 70% of people harbouring a brain AVM will experience a brain bleed in their lifetime

Brain bleeding can also happen from aneurysms, learn more here

Treatment of a brain AVM

Treatment of a brain AVM simply means abolishing the abnormal collection of blood vessels that we call the AVM Nidus, the location of the abnormal connection between the artery & the vein we just mentioned

This can be done in 3 ways ; the most famous way being done nowadays in most centers in the world is brain AVM treatment by Brain catheter

So what is a brain catheter ?

Catheters are small medical tubes that are introduced in the arterial system by a small puncture in the femoral artery in the groin

Catheters can be visualized under certain X-ray machines, and thus are navigated into the human arterial tree to reach it’s desired destination

Brain AVM

A catheter is inserted in the artery in the groin and navigated to reach the Brain AVM

Medical dye is injected in the lumen of the catheter (tube) to help us colour and examine the arteries and veins on our x-ray machines

The brain AVM is accessed by a catheter, a small one actually, called a Microcatheter, to fit in the caliber of the tiny cerebral arteries

After that a medical cement paste like substance is injected to seal the abnormal brain AVM vessels

Brain AVM

Treatment of brain AVM by injection of a medical cement material through a tiny catheter

This stops the blood flow inside the AVM and protects the patient from having a future brain bleed

Other forms of treatment or abolishing an AVM is through Surgery, that involves opening the skull and removing the AVM after clamping it’s feeding arteries and draining veins

Surgery is effective but also very risky, so it needs extremely high experience and very good hands

The last resort to obliterate the AVM vessels is by focusing a very high frequency radiation beam that causes occlusion of the vessels

This treatment is called Gamma knife radiosurgery, the drawbacks of this non invasive treatment modality is that ; the targeted AVM takes 3 years to occlude, and in many cases, it may not occlude after 3 years

Brain AVM

Focusing Radiation on the site of the AVM can induce ablation

Also, it treats only AVMs with certain criteria; small, in certain locations in the brain

If you which to ask more questions about brain AVM

Please feel free to contact us



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Dr. Mostafa Farid, MD, EDiNR
Interventional Neuroradiology Consultant
Faculty of Medicine
Ainshams University Hospital
Cairo, Egypt