Central nervous system vascular malformations are rare abnormalities of blood vessels in your brain or spinal cord and their membranes. There are many types of Central nervous system vascular malformations: Arteriovenous malformations (blood vessels in your brain), Capillary telangiectasias (capillaries), Cavernous malformations (blood vessels in your brain or spinal cord that have the appearance of a mulberry), Dural arteriovenous fistulas (abnormal connections between arteries and the tough covering over the brain or spinal cord), Spinal arteriovenous malformations (abnormal tangle of blood vessels on, in or near your spinal cord), Venous malformations (abnormally enlarged veins in your brain or spinal cord).
Pathophysiology: Arteriovenous malformations (AVMs) are defects of the circulatory system that are generally believed to arise during embryonic or fetal development or soon after birth. They are comprised of snarled tangles of arteries and veins. Arteries carry oxygen-rich blood away from the heart to the body’s cells; veins return oxygen-depleted blood to the lungs and heart. The absence of capillaries—small blood vessels that connect arteries to veins—creates a short-cut for blood to pass directly from arteries to veins. The presence of an AVM disrupts this vital cyclical process. Although AVMs can develop in many different sites, those located in the brain or spinal cord—the two parts of the central nervous system—can have especially widespread effects on the body. The purpose of this text is to provide patients who are diagnosed with central nervous system vascular malformations with some background information regarding the nature of their problem and the possible alternatives in terms of treatment.
Diagnosis : When a patient is first diagnosed with a cerebrovascular malformation, many questions arise. The malformation may be diagnosed after a hemorrhage or as a result of a seizure or possibly as a result of headaches. With improved techniques used to visualize the brain with newer radiographic studies, the diagnosis of an asymptomatic or minimally symptomatic lesion is increasing. Regardless of how the diagnosis is made, once it is decided that a vascular malformation is present, the next step is to ascertain the exact type of vascular malformation, which influences heavily the need for treatment and the exact details of potential treatment.