Arteriovenous Malformations

What is this condition? – overview of the various

Abnormal meshwork of vessels connecting arteries with veins is called AVM or Arteriovenous malformations. It effects only 1% of population and a lot of time the people who have AVM do not have any symptoms and often get to know about this condition while getting treated for unrelated health issue.

What are the causes of this condition?

The blood vessels that are weak which results is directing the blood away from the normal tissue is why this condition occurs. Though the exact reason as to why this happens is unknown yet it can be predicted that

• Most of the patients have this defect since birth.
• They can even acquire this later in life which now-a-days is seen in many cases.
• Or this can even be genetic.

How does it impacts one’s health or what are the risk associated with this condition?

It usually presents with seizures (fits/Epilepsy) or hemorrhage (bleeding in the brain).

Bleeding in the brain can present in any of the form below:

• Severe headache
• Weakness, numbness or paralysis
• Vision loss
• Difficulty speaking
• Confusion or inability to understand others
• Severe unsteadiness

So recurrent fits can disturb psychosocial balance of patients especially school going and growing children. Bleeding in the brain can be catastrophic leading to permanent disability or death.

What are the various treatments & procedures associated with these conditions & diseases?

There are many treatment options. All these options or modalities can be applied as standalone or as a combination of various modalities depending upon medically chosen criterias. Usually group of doctors sit together and chalk out plan of management.

Options are:

1. Medical – This option is suggested when AVM causes headaches or seizures.
2. Surgical – The surgical option is bought into use when the AVM has led to bleeding in the brain and the area is easily accessible. In this the tangled vessels are removed from the brain. 
3. Endovascular – This may be performed alone or can also be performed before or after surgery. This helps in reducing the size of the AVM making the surgery safe.
4. Radiotherapy – In this, the highly energized radiations are focused on the AVM. These high energy beams eventually destroys them.

Can you elaborate on the experiences and achievements of the Max doctors in that makes them THE BEST?

Max doctors are among the most experienced in treating AVM either with surgical excision or Endovascular embolization of AVM. Being a rare disease it needs to be treated in a center where group of doctors discuss and operate. So, Max stands out to be the unique and best center.

What are the latest tools, equipments & technologies that Max has and uses in treatment of above condition? Also, please tell us more about such tools that are used to treat the different conditions and diseases.

• Brain Suite
• Introperative Neuromonitoring
• Awake Craniotomy
• Neuro-Amgio Suite

What are the complexities/risk associated with the treatment of mentioned condition?

If it is located in the critical location of the AVM in the brain, the results can be really complicated with severe issues. It can even lead to bleeding in the brain or even brain damage.

What treatment approaches do you follow for the different therapies and treatments in general?

Treatment approaches depends upon how the patients presents with what symptoms and whether the AVM has bled or not or depending upon radiological factors what are the chances of bleeding in future. All these factors are taken into consideration and then decide on management protocol with either one or combination of following treatment options.

1. Medical
2. Surgical
3. Endovascular
4. Radiotherapy

Please elaborate on the Follow-up procedures, after-care, and daycare services associated with treatment of this condition.

During follow up and also in pre-op work up, the patient need to undergo Cerebral DSA which is a day care procedure. This is important to monitor the condition.

Which other departments work during the treatment of this condition/disease?

Most important and critical to treatment is Neurocritical Care. So other department which works in close association with treatment of this condition is Neurocritical care department right from pre-operative workup, operative procedure and post-operative care.

Other department which patients needs as after-care is Neuro Rehabilitation.

1) What form of support do patients receive? Are there any special support groups or boards or clubs? For example, Oncology has a Tumor board.

Disable patient will need physiotherapy support. Patient having recurrent seizures or fits will need support of Epilepsy support group.

2) In your opinion, what sets Max Healthcare apart in terms of treatment provided?

Group of doctors from various specialties work together with the common goal to manage this difficult condition as this condition cannot give fruitful results with just single therapy.

3) What makes the treatments provided by MAX unique? (Why is Max different from other hospitals in the same)

Best of the equipments

Best of the infra structure in the form of Brani Suite, Intraoperative neuro monitoring and Neuro-angio suite

Best Specialists with most experienced team.