Cerebrovascular malformations

Cerebrovascular malformations (CVMs) are abnormalities in the blood vessels of the brain. There are three main types of blood vessels involved – arteries, veins and capillaries. These vessels play crucial roles in supplying oxygen and nutrients to brain cells and removing waste products.

Arteries carry oxygen-rich blood from the heart to the brain, while veins bring oxygen-depleted blood back to the heart. Capillaries are tiny blood vessels that connect arteries to veins and facilitate the exchange of oxygen and nutrients with surrounding tissues.

In CMVs, these blood vessels can develop abnormally. Arteries may become tangled or enlarged, veins may swell and capillaries may form abnormal clusters. These abnormalities can disrupt normal blood flow in the brain and increase the risk of complications such as bleeding or a stroke.

Types of Cerebrovascular malformations

There are three primary types of cerebrovascular malformations. Each has their own distinct characteristics, symptoms and complications.

Arteriovenous malformations

Arteriovenous malformations (AVMs) happen when arteries and veins in the brain connect directly, skipping the usual capillary network. This direct connection disrupts normal blood flow patterns.

AVMs might not show symptoms until they rupture, causing severe headaches, seizures or neurological deficits. Risks include bleeding into the brain (hemorrhage), which can lead to stroke or brain damage.

Aneurysm

A brain aneurysm is a weak spot in the wall of a blood vessel in the brain. Think of it like a bulge or a balloon that forms on the blood vessel. Over time, the wall of the blood vessel can become thin, and this weak spot can balloon outwards.

Sometimes, aneurysms don't cause any symptoms and are found incidentally. But if an aneurysm bursts or leaks, it can cause a sudden and severe headache, nausea, vomiting or even the loss of consciousness.

Certain factors can increase the risk of developing a brain aneurysm, such as high blood pressure, smoking or a family history of aneurysms.

Cavernous malformations

Cavernous malformations are clusters of abnormal, thin-walled veins in the brain. These clusters can leak blood or cause seizures.

Symptoms of cavernous malformations vary but can include headaches, seizures or neurological deficits. Risks include bleeding, which can lead to stroke or brain damage. Potential complications include permanent neurological deficits.

Venous malformations

Venous malformations involve abnormal development of veins, resulting in slow blood flow. These malformations can occur in the brain or elsewhere in the body.

Venous malformations might not show symptoms until they grow or bleed. Risks include blood clot formation or bleeding. Potential complications include pain, neurological deficits or damage to surrounding tissues.

Less common types of vascular malformations include developmental venous anomalies (DVAs) and capillary telangiectasias. DVAs are usually harmless but can cause neurological symptoms if they bleed. Capillary telangiectasias are small, dilated blood vessels that rarely cause symptoms but can bleed if they rupture.

Symptoms of cerebrovascular malformations

Symptoms of cerebrovascular malformations can vary depending on the type and location of the malformation. The most common sign of a CVM is headaches that can range from mild to severe but feel different from a typical headache.

Other common signs to watch out for include:

• Seizures
• Weakness or numbness in parts of your body
• Difficulty speaking or understanding speech
• Coordination problems
• Vision or hearing changes

If you experience any of these cerebrovascular malformation symptoms, schedule an appointment with your provider right away.

Risk factor of cerebrovascular malformations

Cerebrovascular malformations can affect anyone, but certain factors can increase the likelihood of developing them. Some common risk factors to be aware of are:

• A family history of cerebrovascular malformation
• Age, especially between the ages of 20 and 40
• High blood pressure
• Smoking
• Certain medical conditions, such as atherosclerosis (hardening of the arteries) or certain genetic disorders

Diagnosing cerebrovascular malformations

To determine if you have a cerebrovascular malformation, your doctor will talk to you about your symptoms and medical history. They'll ask questions about any headaches, seizures or other symptoms you've been having, as well as any risk factors you might have, such as a family history of cerebrovascular malformations.

During the physical exam, your doctor will look for any signs of a cerebrovascular malformation, such as abnormalities in your eyes or changes in your reflexes. They may use image tests such as a CT scan or MRI to get detailed images of your brain.

Depending on the severity of your symptoms and the results of the imaging tests, your provider might order other tests such as blood tests to check for signs of infection or inflammation, or an electroencephalogram (EEG) to check for abnormal brain activity.

Treatment for cerebrovascular malformations

When it comes to treating cerebrovascular malformations, your doctor will utilize the latest treatments, which may vary depending on the size, location and severity of the malformation.

In some cases, your doctor might prescribe medications to help manage your symptoms or reduce the risk of complications.

If your cerebrovascular malformation is causing symptoms or is at risk of rupturing, surgery might be necessary. The type of surgery you have will also depend on factors like the size and location of the malformation, as well as your overall health.

If your cerebrovascular malformation isn't causing symptoms or you are at low risk of complications, your doctor might monitor your health over time with regular check-ups or testing.

If a cerebrovascular malformation has caused neurological deficits, such as muscle weakness or difficulty speaking, doctors might recommend physical therapy, occupational therapy or speech therapy.