From the Guidelines
Yes, arteriovenous malformations (AVMs) of the brain can cause headaches, affecting approximately 15% of patients with this condition. According to the study by 1, headaches are one of the common presentations of brain AVMs, although they are less frequent than intracranial hemorrhage or seizures. The headaches may vary in intensity and character, and can be an indicator of the location of the lesion.
Key Points to Consider
- AVMs create abnormal connections between arteries and veins, bypassing normal capillary beds, which can disrupt normal blood flow patterns and cause increased pressure in surrounding brain tissue 1.
- AVMs may trigger headaches through several mechanisms: they can irritate pain-sensitive structures in the brain, cause small bleeds that irritate the meninges, or steal blood from surrounding brain tissue leading to localized oxygen deficiency.
- If you experience persistent, severe, or unusual headaches, especially if accompanied by other neurological symptoms like seizures, weakness, vision changes, or speech difficulties, you should seek immediate medical attention as these could indicate a potential AVM complication such as bleeding.
Diagnosis and Treatment
- The diagnosis of AVMs typically involves MRI and angiography to delineate the anatomy of the AVM 1.
- Treatment options for AVMs include radiosurgery, which has been found to be a safe and effective treatment for specific AVMs, leading to complete AVM obliteration in approximately 80% of patients within 2 to 3 years 1.
From the Research
Arteriovenous Malformations (AVM) and Headaches
- AVMs are complex vascular lesions commonly associated with chronic headache 2
- The location of the malformation, particularly in the occipital lobe, can increase the risk of concurrent migraine-like headaches in AVM patients 2, 3
- Headache associated with AVMs often shows characteristics of migraine with and without aura 3
Clinical Characteristics of AVM-Associated Headaches
- Migraine-like headache is a common clinical manifestation in patients with AVMs, particularly those with occipital lobe malformations 3, 4
- The incidence of headache in patients with AVMs can be as high as 45.9% 4
- Factors associated with a higher incidence of headache include larger nidus volume, tortuous change of feeding artery, and cortical drainage with reflux in the superior sagittal sinus 4
Treatment and Outcomes
- A multidisciplinary approach to eradicate cerebral AVM can be effective in treating headaches associated with AVMs 2
- Radiosurgery can resolve headaches in the majority of treated patients, with an actuarial rate of angiographic obliteration of 71.6% at 3 years 4
- The outcome of headache closely correlates with the obliteration results of the AVM 4