The Cerebrovascular Surgery and Interventions Center treats arteriovenous malformations of the brain and other cerebrovascular conditions. Arteriovenous malformations (AVMs) are errors in blood vessel development in which tangles of arteries and veins connect abnormally. They can occur in the brain or elsewhere in the body. Brain AVMs are usually present at birth.
Read more on AVMs in other parts of the body.
Brain AVMs often cause no symptoms at all and are discovered during imaging for other reasons. More commonly, though, we see children with AVMs that have caused bleeding in the brain, seizures and other neurological problems. Symptoms may vary depending on the location of the AVM and can include:
- persistent headaches
- weakness or paralysis on one side of the body
- problems with speaking
- loss of coordination
- numbness, tingling or pain
How we care for brain AVMs at Boston Children's Hospital
In treating brain AVMs, we seek to minimize the child’s long-term neurologic risks. In addition to treating the AVM itself, our specialists in neurology, physical/occupational therapy and speech/language therapy address any neurological symptoms that the AVM may have caused.
Before treating a brain AVM, we carefully image it and the surrounding vessels and brain tissue using a variety of noninvasive techniques, each giving different kinds of information. When the AVM is accessible, and there is little danger of interfering with vital brain functions, we attempt to remove it surgically. If the AVM is complex, especially if it involves deep, hard-to-reach vessels, we may recommend endovascular embolization before operating. When the AVM’s location in the brain makes direct surgery too risky, and the AVM is small, we may recommend radiosurgery.
The Cerebrovascular Surgery and Interventions Center has pioneered the practice of performing an additional angiogram after treatment, before waking the child from anesthesia, to verify that the entire AVM has been removed. This is important, because even a small portion of an AVM left in the brain can pose a risk of bleeding.
Read more by clicking the Tests and Treatments tabs above.