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Encyclopedia > Cerebral arteriovenous malformation
Cerebral arteriovenous malformation
Classifications and external resources
ICD-10 Q28.2
ICD-9 747.81
eMedicine neuro/21 

A cerebral arteriovenous malformation (AVM) is a congenital disorder of blood vessels within the brain, characterized by tangle(s) of veins and arteries. While an arteriovenous malformation can occur elsewhere in the body, this article discusses malformations found in the brain. The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... A congenital disorder is a medical condition that is present at birth. ... The arterial system The blood vessels are part of the circulatory system and function to transport blood throughout the body. ... A sketch of the human brain by artist Priyan Weerappuli, imposed upon the profile of Michaelangelos David. ... In biology, a vein is a blood vessel which carries blood toward the heart. ... Section of an artery For other uses see Artery (disambiguation) Arteries are muscular blood vessels that carry blood away from the heart. ... Arteriovenous malformation or AVM is a congenital disorder of the veins and arteries that make up the vascular system . ...

Contents

Symptoms

The most frequently observed problems related to the mechanical and blood loss (ischemic) effects of an AVM are headache and seizure. Moreover, AVMs in certain critical locations may stop the circulation of the cerebrospinal fluid, causing accumulation of the fluid within the skull and giving rise to a clinical condition called hydrocephalus. In medicine, ischemia (Greek ισχαιμία, isch- is restriction, hema or haema is blood) is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. ... A headache (medically known as cephalalgia, sometimes spelled as cephalgia) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... This article is about the medical term, epileptic seizure, as distinct from psychogenic non-epileptic seizure. ... Cerebrospinal fluid (CSF), Liquor cerebrospinalis, is a clear bodily fluid that occupies the subarachnoid space in the brain (the space between the skull and the cerebral cortex—more specifically, between the arachnoid and pia layers of the meninges). ...


Symptoms of bleeding within the brain (intracranial hemorrhage) include loss of consciousness, sudden and severe headache, nausea, vomiting, incontinence, and blurred vision. A stiff neck can occur as the result of increased pressure within the skull and irritation of the meninges. Impairments caused by local brain tissue damage on the bleed site are possible, including seizure, hemiparesis, a loss of touch sensation on one side of the body, or deficits in language processing (aphasia). A variety of other symptoms can accompany this type of cerebrovascular accident. This article needs cleanup. ... Look up incontinence in Wiktionary, the free dictionary. ... Hemiparesis is the partial paralysis of one side of the body. ... Aphasia (also Aphemia - from Greek α, without, and φημη, speech), is a loss or impairment of the ability to produce and/or comprehend language, due to brain damage. ... A stroke or cerebrovascular accident (CVA) occurs when the blood supply to a part of the brain is suddenly interrupted by occlusion (an ischemic stroke- approximately 90% of strokes), by hemorrhage (a hemorrhagic stroke - less than 10% of strokes) or other causes. ...


Generally, intense headache, perhaps coincident with seizure or loss of bodily consciousness, is the first indication of a cerebral AVM. Estimates of the number of AVM-afflicted people in the United States range from 0.1% to 0.001% [1] [2] of the population.


Diagnosis

An AVM diagnosis is established by neuroimaging studies. A computed tomography scan of the head (head CT) is usually performed; this can reveal the site of the bleed. More detailed pictures of the tangle of blood vessels that compose an AVM can be obtained by using radioactive reagents injected into the blood stream, then observed using a fluoroscope or Magnetic Resonance Imaging (MRI). A spinal tap (lumbar puncture) can be used to examine spinal fluid for red blood cells; this condition is indicative of leakage of blood from the bleeding vessels into the subarachnoid space. The best images of an AVM are obtained through cerebral angiography. This procedure involves using a catheter, threaded through an artery up to the head, to deliver a contrast agent into the AVM. As the contrast agent flows through the AVM structure, a sequence of X-ray images can be obtained to ascertain the size, shape and extent of that structure. Neuroimaging includes the use of various techniques to either directly or indirectly image the structure, function, or pharmacology of the brain. ... CT apparatus in a hospital Computed tomography (CT), originally known as computed axial tomography (CAT or CT scan) and body section roentgenography, is a medical imaging method employing tomography where digital geometry processing is used to generate a three-dimensional image of the internals of an object from a large... The fluoroscope is a medical instrument used by physicians to view the internal organs of the body best described as a motion X-ray. Like an x-ray machine it takes an image of the interior of the body, but unlike the x-ray it uses a powerful radiation source... This article or section does not cite its references or sources. ... A patient undergoes a lumbar puncture at the hands of a neurologist. ... The meninges (singular meninx) are the system of membranes that contain the brain. ... Cerebral angiography or arteriography is a form of medical imaging that visualises the arterial and venous supply of the brain. ...


Pathophysiology

While the cause of AVMs remains unknown, the main risk is intracranial hemorrhage. This risk is difficult to quantify. Approximately 70% of cases with cerebral AVM are discovered through symptoms caused by sudden bleeding due to the fragility of abnormally-structured blood vessels in the brain. However, some patients may remain asymptomatic or have minor complaints due to the local effects of the tangle of vessels. If a rupture or bleeding incident occurs, the blood may penetrate either into the brain tissue (cerebral hemorrhage) or into the subarachnoid space. This space is located between the sheaths (meninges) surrounding the brain (subarachnoid hemorrhage). This article needs cleanup. ... A cerebral hemorrhage or hemorrhagic stroke is a form of stroke that occurs when a blood vessel in the brain ruptures or bleeds. ... The meninges (singular meninx) are the system of membranes that contain the brain. ... The meninges (singular meninx) are the system of membranes that envelop the central nervous system. ... A subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space surrounding the brain, i. ...


Once an AVM bleeds, the probability of rebleeding increases substantially.


AVMs that do not bleed may cause symptoms by either directly compressing the brain tissue or decreasing the blood flow to the neighbouring tissue (ischemia). Both mechanical and ischemic factors cause a permanent and continuous loss of nerve cells (neurons). In medicine, ischemia (Greek ισχαιμία, isch- is restriction, hema or haema is blood) is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. ... Neurons (also called nerve cells) are the primary cells of the nervous system. ...


Treatment

The treatment in the case of sudden bleeding is focused on restoration of vital function. Anticonvulsant medications such as phenytoin are often used to control seizure; medications or procedures may be employed to relieve intracranial pressure. Eventually, curative treatment may be required to prevent recurrent hemorrhage. Phenytoin sodium (marketed as Dilantin® in the USA and as Epanutin® in the UK, by Parke-Davis, now part of Pfizer) is a commonly used antiepileptic. ...


Surgical removal of the blood vessels involved (craniotomy) is the preferred curative treatment for most types of AVM. While this surgery results in an immediate, complete removal of the AVM, risks exist. A craniotomy is a surgical operation in which part of the skull (part of the cranium) is removed in order to access the brain. ...


Radiation treatment (radiosurgery) has been widely used on smaller AVMs with considerable success. The Gamma Knife, developed by Swedish physician Lars Leksell, is one apparatus used in radiosurgery to precisely apply a controlled radiation dosage to the volume of the brain occupied by the AVM. While this treatment is non-invasive, two to three years may pass before the complete effects are known. Complete occlusion of the AVM may or may not occur. Radiosurgery is a medical procedure which allows non-invasive brain surgery, i. ... Lars Leksell (1907-1986) was a Swedish physician and Professor of Neurosurgery at the Karolinska Institute in Stockholm, Sweden. ... The term non-invasive in Medicine has two meanings: A medical procedure which does not penetrates or breaks the skin or a body cavity, i. ... A term indicating that the state of something, which is normally open, is now totally closed. ...


Embolization, that is, occlusion of blood vessels with coils or particles introduced by a radiographically guided catheter, is frequently used as an adjunct to either surgery or radiation treatment. However, embolization alone is rarely successful in completely blocking blood flow through the AVM. A non-surgical, minimally-invasive procedure involving selective occlusion of blood vessels by purposefully introducing emboli to treat such conditions as aneurysms, epistaxis, and uterine fibroids. ...


External links


  Results from FactBites:
 
Arteriovenous Malformations (1091 words)
Arteriovenous malformations (AVMs) are defects of the circulatory system that are generally believed to arise during embryonic or fetal development or soon after birth.
Arteriovenous malformations that are inoperable because of their location are sometimes treated solely by embolization; although the risk of hemorrhage is not reduced, neurologic deficits may be stabilized or even reversed by this procedure.
Arteriovenous Malformations is important to get plenty of rest, so the patient may be in a darkened room and should try to keep as quiet and comfortable as possible.
Arteriovenous Malformation - Cerebral - Health Centers (654 words)
A cerebral arteriovenous malformation is a birth defect in which there is an abnormal connection between the arteries and veins in the brain.
Arteriovenous malformations vary in their size and location within the brain.
Cerebral arteriovenous malformations occur in less than 1% of people.
  More results at FactBites »

 
 

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