AVM and Other Cerebrovascular Diseases
Blood flow and your brain
“Cerebrovascular disease” refers to conditions that affect blood flow in the brain. Problems occur when blood vessels rupture or when arteries become narrow or blocked. These are life-threatening conditions, sometimes leading to stroke or long-term disability.
The neurointervention experts at Aurora BayCare are highly-skilled specialists, trained to diagnose these conditions and either prevent an emergency event or treat an event already in progress, limiting brain damage and giving patients an opportunity to make a full recovery.
A brain aneurysm occurs when a weak spot in an artery wall bulges and fills with blood. This is a potentially life-threatening condition. If an aneurysm bursts, it can cause a stroke, brain damage, or death. Read about the symptoms of an aneurysm.
Arteriovenous Malformations (AVM)
An AVM is a tangle of blood vessels in the brain that can cause intracranial bleeding. Using neurointervention procedures, blood vessels can be blocked to cut off the AVM’s blood supply, making surgical removal faster and safer.
An arteriovenous malformation (AVM) is an abnormal connection between your veins and arteries. Usually present from birth, an AVM can interfere with normal blood circulation. Although these malformations can occur anywhere in the body, an AVM on your brain or spinal cord can cause seizures, headaches, stroke or paralysis.
Brain AVM symptoms:
Spinal cord AVM symptoms:
- Lack of coordination
- Inability to move a limb
Treatment for AVMs is often designed to prevent internal bleeding and/or manage related symptoms. AVMs can be treated surgically with a minimally invasive neurointervention procedure called endovascular embolization.
Carotid Artery Disease
Carotid artery disease occurs when a waxy substance called plaque builds up inside the carotid arteries—the major arteries that supply blood flow to your brain. This blockage decreases blood flow to your brain and can lead to stroke.
Factors that may contribute to carotid artery disease include high blood pressure, high cholesterol, diabetes, physical inactivity, smoking, and advanced age. Typically, no symptoms are evident until a carotid artery becomes completely or nearly blocked. At that stage, you are at high risk for a transient ischemic attack (TIA) or a stroke.
Symptoms of Carotid Artery Disease include:
- Sudden headaches
- Drooping on one side of your face
- Speech problems
- Vision problems
- Weakness in your arms or legs
Treatment for carotid artery disease will vary based on your condition and history of stroke. If you have carotid artery disease, but have not had a stroke, your doctor may recommend medications and lifestyle changes. Treatment after a stroke typically involves neurosurgery or a neurointervention procedure to remove the blockage.
Cavernous Malformation (Cavernoma)
A cavernous malformation (also called a cavernoma or cav mal) is a vascular malformation or abnormality in the blood vessels. A cavernoma presents a threat when it occurs in the brain or spinal cord. These are rare, complicated conditions and treatment varies depending on the size and location of the malformation.
If your cavernoma is not causing symptoms, doctors may recommend ongoing monitoring. Surgical treatment may be considered if you are experiencing any of the following symptoms of a cavernoma:
- Progressive brain damage
An intracerebral hemorrhage occurs when a diseased blood vessel within the brain bursts, allowing blood to leak inside the brain. This sudden pressure can damage brain tissue and may lead to unconsciousness or death. This condition is also known as a hemorrhagic stroke.
Surgery may be required to treat a hemorrhagic stroke. The doctor may also recommend surgical removal if the hemorrhagic stroke was caused by an AVM. Open and minimally invasive surgical options are available depending on each case:
- Surgical clipping, to cut off blood flow to an aneurysm
- Coiling or embolization to cause a clot to form in the affected area
- Flow diverter to prevent blood from reaching a weakened area.
Intracranial stenosis is the severe narrowing of an artery within the skull. Restricted blood flow increases the risk of stroke. A stroke is one key indicator of intracranial stenosis, however patients may experience “mini stroke” symptoms such as sudden headaches, numbness, speech or visions problems, partial paralysis, or vertigo.
Treatments are designed to reduce the risk of a stroke. Medications may be recommended. Surgical interventions may include angioplasty or stenting, bypass surgery, or surgical removal of plaque (endarterectomy).
Fibromuscular Dysplasia (FMD)
People with fibromuscular dysplasia, or FMD, have abnormal cell development in an artery wall. This may lead to a narrowing of the arteries, to aneurysms, or tears in the artery wall. FMD most commonly affects arteries that supply the kidneys or the carotid arteries that supply the brain. When FMD symptoms do present, they are often associated with the affected organ.
Symptoms of FMD could include:
- High blood pressure
- Abnormal kidney function
- Neck pain
FMD is a rare disease that is more common in women with men. Treatments, which vary based on each individual and the severity of the condition, may include medications or angioplasty, vascular coils, or stenting.
Head, Neck and Spine Tumors
A tumor is an uncontrolled growth of cells. These can be cancerous (malignant) or noncancerous (benign). While benign tumors do no invade adjacent cells, they may still cause serious symptoms as they press on vital areas.
Symptoms of Spinal Cord and Brain Tumors:
- Drowsiness or coma
- Nausea or vomiting
- Blurred vision
- Loss of balance or coordination
Surgical removal is often recommended. Brain and spine tumors can be easier to remove if their blood supply is reduced prior to surgery. A neurointervention procedure can be used to block the blood vessels that supply blood flow to a tumor. Known as “pre-operative tumor embolization,” this makes surgical removal faster and safer.
Radiation therapy is used to treat tumors that cannot be accessed by surgery. The radiation does not remove the tumor but can shrink it. Chemotherapy and targeted drug therapy may also be used to treat cancerous tumors.
Moyamoya disease, or Moyamoya syndrome, is a rare but serious condition caused by blocked arteries at the base of the brain. Moyamoya is a progressive disease in which the walls of the carotid arteries narrow over time. Blood flow to the brain is reduced, putting the patient at risk for a stroke.
Fragile new blood vessels form, to compensate for the blockage. These vessels can break and bleed into the brain, causing hemorrhages. While the disease mainly affects children, some adults have the condition. Symptoms mirror those of a stroke. Treatment requires surgery to create a new way for blood to supply the impacted areas of the brain.
Stroke and TIA
A transient ischemic attack (TIA), or mini stroke, is a sudden onset of stroke symptoms that last for a brief period. A mini stroke does not cause permanent brain damage, but it is considered a serious warning sign that needs immediate medical treatment. About a third of the patients who experience a TIA will suffer a stroke in the following year. Learn more about TIA.