arteriovenous malformation - a congenital anomaly violation of the mutual arrangement of vessels with pathognomonic localization in the cerebral hemispheres, but found in other anatomical regions, different propensity to develop complications such as damagethe integrity of the vascular wall.
result of the formation of tangles dilated vessels in which the veins and arteries are not delimited from each other by capillary penetration becomes arterial blood to the veins and carried out the reverse transport of carbon dioxide, which provokes the development of acidotic and hypoxic complications.
degree of hemodynamic parameters in the presence of arteriovenous malformation depends on the metric parameters of abnormally positioned vessels, which can be observed in a wide range.
reasons arteriovenous malformation
Many randomized studies was devoted to the study of etiopathogenesis of arteriovenous malformation and, unfortunately, so far there is no reliable inform
The undeniable fact is simply that arteriovenous malformation occurs in humans even in utero and is classified as congenital anomalies of embryogenesis.
Joint research conducted by geneticists and embryologists ended in the discovery that the maximum possibility of malformations observed in the first week of embryonic development, and it is up to the sixth week.After the seventh week until the end of the second trimester of pregnancy marked the development of the arteriovenous malformation of a particular location.
Due to the rapid development of radiation detection techniques arteriovenous malformation diagnosis of some pathological variants, it is possible in the early stages of development.However, due to the lack of reliable data on the origin of the disease still is not possible to develop methods for primary prevention.
Thus, the maximum pathogenetic role of arteriovenous malformation any location remains embryonic nature of the factors.
According to world statistics of the incidence of arteriovenous malformations, there are the data and the secondary development of the anomalies resulting from the negative impact of ionizing radiation suffered by inflammation of the brain.In addition, the risk of developing arteriovenous malformation are persons suffering from sickle-cell anemia form.
Also, many experts point correlation between the development of arteriovenous malformation and gender of the patient (more on this disease affects men).
Symptoms arteriovenous malformation
Depending on your patient's clinical symptoms, arteriovenous malformation has several flow.So, in hemorrhagic type of flow, which is observed in 70% of cases, the patient noted a tendency to raise blood pressure numbers and predominantly localized in the projection of the posterior fossa.For arteriovenous malformation of this type are not characterized by the development unit malformation large.
hemorrhagic variant flow arteriovenous malformation is often the cause of disability and the patient has a high risk of hemorrhage.
In 50% of cases of hemorrhagic type arteriovenous malformation marked development pathognomonic clinical picture of subarachnoid hemorrhage.Morbidity hemorrhagic type arteriovenous malformation is the formation of intracerebral hematoma, subdural and mixed localization and hemotamponade ventricles.
torpid for arteriovenous malformation occurs during the formation of large-sized units, localized in the cerebral cortex and the blood supply it with the branches of the middle cerebral artery.
for clinical symptom in the torpid flow arteriovenous malformation in the first place stands increased convulsive readiness, cluster headache, progressive focal neurological symptoms that occurs in tumor lesions of the brain.
Note that the arteriovenous malformation of the lungs, for example, are not always characterized by the development of the classical variant of the flow in the form of progressive respiratory distress, cyanotic changes in the skin and thickening of the nail phalanxes.In some situations, a person can be observed even a long asymptomatic period.At a late stage of the localization of arteriovenous malformation in the lungs is accompanied by development of severe manifestations of respiratory and heart failure.
most pathognomonic clinical manifestation of pulmonary arteriovenous malformation is considered progressive shortness of breath.With complicated flow arteriovenous malformation this localization in the patient may experience episodes of hemoptysis.
auscultation signs of pulmonary arteriovenous malformations is the appearance of noise in the projection of the node malformation, increasing the moment of maximum inspiration with the patient "lying on his right side."
arteriovenous malformation of the spinal cord often not accompanied by the development of specific pathognomonic symptoms that distinguish it from other diseases associated with lesions of the spinal cord structures.The first clinical manifestations of this situation are the various kinds of disorders of varying depth sensitivity and motor activity.
arteriovenous malformation of the brain
view of the wider use of new methods of radiation diagnosis of brain structures significantly increased performance verification arteriovenous malformation, despite the fact that the clinical symptoms of this pathology is not apparent.
At the same time, some categories of patients, on the other hand, there is the rapid development of symptoms, the specificity of which depends on the location of the malformation in a particular brain structure.By
cerebral manifestations resulting from increased intracranial pressure include: pain in the head Expander character, accompanied by vomiting, bringing relief, weakness, inability to perform even minimal physical activity.Specific neurological manifestations of arteriovenous malformations localized in the frontal lobes is to reduce intellectual-mental capacity, the emergence of motor aphasia, display abnormal sucking reflex, unsteadiness when walking, tendency to seizures
most specific manifestations of arteriovenous malformation of the cerebellum are the focal violations, lack of walking andkrupnorazmashistogo appearance of horizontal nystagmus, hypotonia.
arteriovenous malformation in the temporal lobe associated with the development of sensory aphasia, visual field loss and increased convulsive readiness.
When placing arteriovenous malformation at the base of the brain in patients develop visual disturbances in the form of strabismus, loss of visual field up to blindness, as well as violations of motor activity in the limbs.
With the development of morbidity in the form of arteriovenous malformation rupture of the vessel wall in a patient develops clinical picture of subarachnoid hemorrhage in a sudden severe headache, photophobia, nausea and vomiting, not bringing relief, short-term or long-term loss of consciousness.
In some situations, streamed out of the vascular blood accumulates and forms a hematoma, which is manifested in the form of visual impairment partial or total blindness, strabismus and eye immobility, paralysis of limbs, speech disorders, seizures and permanent loss of consciousness.
As regards diagnostic procedures, allowing significantly not only to verify the diagnosis "arteriovenous malformation of the brain", but the exact localization of the problem, using cerebral arteriography contrast.
Treatment of arteriovenous malformation
When selecting the optimal appropriate and pathogenetically sound method of treating a patient suffering from arteriovenous malformations before the doctor the task of correct assessment of the health status of the patient, the intensity of the clinical manifestations, pinpointing anomalies and its size.
Medical treatment for arteriovenous malformation, as a rule, is purely symptomatic and involves the use of analgesic drugs, anticonvulsant action.
More recently, neurologists prefer to use watchful waiting for patients suffering from arteriovenous malformation, provided that it is a favorable course.Currently, there are a whole range of operational benefits, eliminates the arteriovenous malformation, and at the same time minimize the risk of complications.
Surgery for arteriovenous malformation involves surgical resection and finds its use only for small malformations.In the case of deep-seated arteriovenous malformation of the brain, this method is not applicable in view of the high risk of intraoperative complications.
Another effective method for correcting operational arteriovenous malformation is embolization, which involves the introduction of a catheter into the location of the malformation site and the introduction of a special substance with adhesive properties, whereby the total flow off of the modified portion.This method acts both as primary treatment and as an adjunct to surgical resection of the classic version, thereby minimizing the risk of intraoperative complications such as bleeding.
In the absence of the patient's risk of hemorrhagic complications permitted the use of radiosurgery, in which a node malformation focus the effects of radioactive substances that have a damaging effect on the arteriovenous malformation.This technique involves the use of radiohirugii course lasting several years before the appearance of a persistent effect of the disappearance of arteriovenous malformation.
arteriovenous malformation - a doctor will help ?In the presence or suspected development of arteriovenous malformation should immediately consult a doctor such as a neurologist and neurosurgeon.