Intracranial Venous Malformations

Intracranial venous malformations are abnormally enlarged veins in brain. Venous malformations are a type of blood vessel abnormality in the brain or spinal cord. 

Brain arteriovenous malformations (BAVMs) are lesions of the cerebral vasculature in which arterial blood flow is shunted directly into the venous system without passing through a capillary system, resulting in high-flow lesions prone to rupture. The estimated detection rate of BAVMs has been reported to be ≈1 per 100 000 person-years, accounting for 1% to 2% of all strokes.1 In order of decreasing frequency, the clinical presentations of BAVMs include hemorrhage, seizures, headaches, and neurologic deficits.2 The primary management aspect of BAVMs is prevention of rupture and the resulting intracranial hemorrhagic event.3 The annual risk of intracranial hemorrhage after diagnosis of BAVMs is ≈2% to 4% per year; the rate is higher for those with initially ruptured and lower for those with unruptured presentations.1,4,5 BAVMs that do not bleed can cause seizures, headaches, or neurologic deficits due to a mass effect and involvement of neighboring eloquent brain regions. 

The most important goal AVM treatment is to prevent internal bleeding from rupture, because which can lead to stroke / death. However, seizure control or stabilization of progressive neurological deficits are occasionally treatment goals. Though medication may be prescribed, it does not cure AVMs but medications are used to control pain and seizures. The management options for brain AVMs include observation or various treatment techniques, such as endovascular embolization, microsurgical techniques and stereotactic radiotherapy used alone or in combination with varying degrees of treatment-associated morbidity and mortality.