An irregular blood vessel network linking arteries and veins known as an arteriovenous malformation (AVM) impairs normal blood flow and oxygen delivery. The brain receives oxygenated blood through arteries. The oxygen-depleted blood is returned to the heart and lungs through veins.

The neighbouring tissues may not receive adequate oxygen when an AVM interferes with this crucial function. Additionally, the abnormally twisted blood arteries that make up the AVM are prone to deterioration and rupture. If the AVM ruptures in the brain, it may result in brain bleeding (haemorrhage), a stroke, or permanent brain damage.

AVMs have an unknown etiology. They don't often get passed down via families. Once identified, a brain AVM may frequently be effectively treated to lower the possibility of problems.

Stages:

An AVM is present from birth, but according to its size and location, it may not be discovered until much later in life. AVMs may emerge following an incident or when a kid develops into an adult.

AVMs develop and transform throughout time. A scale known as the Schöbinger staging system is frequently used to categorize AVMs. Every step is not completed by every AVMS.

1. Stage I (quiescence): The AVM is "silent" in this stage and the skin on top of it may be warm and pink or red.
2. Stage II: The AVM grows in size in this stage. In the AVM, a pulse might be detected or audible.
3. Stage III (destruction): The AVM produces discomfort, bleeding, or ulceration
4. Stage IV:  This results in Heart failure.

Symptoms:

AVMs may irritate nearby brain tissue, which may result in headaches or seizures. Any of the following signs might show up:

• Seizure onset
• A weakened or paralysed muscle
• Inability to coordinate
• Having trouble doing organisational chores
• Dizziness
• Headaches
• Visual alterations
• Language issues
• Abnormal feelings of numbness, tingling, or sudden pain
• Memory issues
• Mental haziness
• Hallucinations
• Dementia

Blood is diverted away from healthy brain tissue by aberrant, hence "weakened," blood arteries found in brain AVMs. Over time, these weak and atypical blood arteries enlarge. They could eventually rupture due to the intense blood pressure coming from the arteries.

Alarming factors:

AVMs' origin is uncertain. Some medical professionals think they develop during pregnancy or soon after delivery and manifest as the kid becomes older.

The skin of newborns with AVM disease may have a blue colour. This results from the body not having enough oxygenated blood flowing through it. As youngsters become older and the illness gets worse, the skin usually darkens to a bright red or purple colour.

Diagnosis:

By examining the afflicted region and the patient's medical history, doctors can identify a variety of AVMs. AVMs are often not inherited, which means they are not passed on from parent to child.

AVMs can occasionally be confused with infantile hemangiomas (IH). When the child is no longer a baby, an AVM grows larger. Only during infancy do IHs expand.

AVMs and capillary malformations (CMs), sometimes known as "port wine stains," can occasionally be confused. The main distinction is that with an AVM, the bigger blood arteries under the skin have fast-moving blood. In a CM, the blood vessels are tiny and exclusively found in the epidermis.

However, the ultimate diagnosis is typically based on imaging studies that highlight regions of blood flow. The following are the tests performed:

1. When there is a possibility that someone may have an AVM, an ultrasound is frequently the first test that is requested. An ultrasound creates an image of the tissues and blood vessels under the skin using sound waves.
2. More precise images of the location and size of an AVM within the body are provided by MRI. The AVM's proximity to other significant structures, such as nerves, that might be impacted by therapy is also shown by MRI.
3. Whether an AVM is impacting a bone can be determined via a CT scan. Similar to an MRI, a CT scan employs X-rays rather than magnetic fields.
4. In order to get a very clear view of the blood arteries, angiography may be prescribed. Anaesthesia is used during an angiogram.

Treatment:

AVM therapy is based on the location of the anomaly, your symptoms, general health, and the danger of the procedure. An AVM may be periodically imaged in order to check for changes or issues. Other AVMs need to be treated. Medication can assist with symptoms including back pain, headaches, and seizures.

Surgery is the primary AVM therapy. If you have a significant risk of bleeding, your doctor could advise surgery. The AVM could be entirely removed through surgery. When the AVM is in a location where it can be surgically removed without significantly damaging the brain structures, this therapy is typically employed.

Conclusion:

AVMs are significant medical conditions that affect the arteries and veins. Some people don't show any signs of an AVM unless they experience bleeding. AVMs can be discovered everywhere in your body, although they are most frequently seen in the brain and spinal cord. Consideration of the possibility that an AVM may bleed and cause serious or perhaps even life-threatening damage if left untreated is one of many factors that must be taken into account when deciding whether to treat an AVM.