Central nervous system vascular malformations

Diagnosis

A doctor searches for a family history of stroke, epilepsy, or associated illnesses to make the diagnosis of a central nervous system vascular malformation. Some vascular malformations produce a bruit, which is a whooshing sound. The bruit is brought on by rapid blood flow through a malformation. Through a stethoscope, a doctor might hear the noise.

Imaging tests

A central nervous system vascular malformation can be found via imaging tests such as an angiogram. Blood flow through arteries or veins can be seen on an angiogram. A contrast dye is injected into the blood, which causes blood vessels to show up on the image. The scan shows the dye lighting up.

To identify a vascular malformation of the central nervous system and to determine the best course of treatment, a Magnetic Resonance Angiogram (MRA) or a Computed Tomography Angiogram (CTA) may be employed.

Regular Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans can detect some vascular malformations, such as cavernous malformations.

Treatment

The type of central nervous system vascular malformation, its location, symptoms, and bleeding risk all affect how it is treated. Sometimes all that is required is to monitor the malformation for changes and the potential for bleeding.

Medicines

Anti-seizure medications to treat seizures and pain relievers for headaches are some medications that may be used to treat the signs and symptoms of a venous malformation.

Surgery or other procedures

There are several vascular malformations of the central nervous system that can be surgically removed. The method is determined by the deformity.

• Surgery. In order to eliminate the malformation, this method entails cutting into the brain or spinal cord. An arteriovenous malformation that is modest and in an accessible location is most frequently treated surgically.

There are complications associated with surgery, such as blood loss and infection. Additionally, there is a chance of harming neighboring healthy tissue.

• Stereotactic radiosurgery. To do this procedure, precise radiation beams are directed at the vascular malformation. The deformity is removed over time as a result of the radiation’s destruction to the blood vessel walls.

The dangers are lower with radiosurgery than with surgery because it doesn’t entail cutting. However, there is a chance that radiation will harm healthy tissue.

• Endovascular embolization. A catheter—a lengthy, thin tube—is used in this procedure. The tube is inserted into an artery that supplies the malformation in the leg or groin. Then, with the aid of X-ray imaging, it is threaded to the brain.

The surgeon inserts coils or anything resembling glue into the tube to restrict the artery and reduce blood flow to the malformation.

The malformation may not be entirely removed by embolization, or the effects may fade quickly. It is frequently used with other surgical techniques.