What diseases are associated with Arteriovenous Malformation (AVM)?

From the Guidelines

Arteriovenous malformations (AVMs) are primarily associated with neurological diseases and complications, most notably intracranial hemorrhage, which can lead to stroke-like symptoms, seizures, and severe headaches 1. The most significant AVM-associated condition is intracranial hemorrhage, occurring in more than 50% of AVM cases, with severe vasospasm from AVM-related hemorrhage being distinctly uncommon 1. Other neurological issues associated with AVMs include:

• Seizures, which occur in 20% to 25% of cases, and can be either focal or generalized, potentially indicating the location of the lesion 1
• Headaches, occurring in 15% of patients 1
• Focal neurological deficits, which are less common, occurring in fewer than 5% of cases 1
• Pulsatile tinnitus, which can also be a presenting symptom 1 In rare cases, AVMs can be part of genetic syndromes such as Hereditary Hemorrhagic Telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, which can cause AVMs in multiple organs, leading to additional complications 1. The presence of an AVM increases the risk of these associated conditions, and early detection and management of AVMs is crucial to prevent potentially life-threatening complications, with the annual risk of intracranial hemorrhage among people with AVMs who present with symptoms other than hemorrhage being approximately 2% to 3% per year 1.

From the Research

Diseases Associated with Arteriovenous Malformation (AVM)

• Arteriovenous malformations (AVMs) are associated with various diseases, including:
  • Intracranial bleeding 2
  • Parenchymal clots 2
  • Intracranial hemorrhage 3, 4
  • Subarachnoid hemorrhage 5
  • Intramedullary hemorrhage 5
• AVMs can also be associated with other cerebrovascular malformations, such as:
  • Developmental venous anomalies (DVAs) 3
  • Spinal arteriovenous fistulas (AVFs) 6
• The presence of aneurysms is also common in AVMs, with up to 18% of AVMs having associated intracranial aneurysms 4

Clinical Presentations

• The clinical presentation of AVMs can vary, but common symptoms include:
  • Hemorrhage 2, 3, 4
  • Paresis/paralysis 6
  • Paresthesias 6
  • Pain 6
  • Bowel/bladder dysfunction 6
  • Myelopathy 6
• The location of the AVM can also affect the clinical presentation, with:
  • Cervical pial AVMs presenting with progressive myelopathy or acute hemorrhage 5
  • Spinal AVMs presenting with paresis/paralysis, paresthesias, and pain 6

Treatment Options

• Treatment options for AVMs include:
  • Surgical resection 2, 6, 5
  • Embolization 2, 3, 4
  • Radiosurgery 3, 4
  • Multimodal therapy 3
• The choice of treatment depends on various factors, including:
  • AVM location and size 2, 6
  • Presence of associated aneurysms or other cerebrovascular malformations 3, 4
  • Patient's overall health and medical history 5