Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
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Home / A–Z Services / Neurovascular Center / What We Treat / Arteriovenous and Vein of Galen Malformations
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Arteriovenous and Vein of Galen Malformations


What is a brain arteriovenous malformation (AVM)?

A brain arteriovenous malformation (AVM) is a congenital blood vessel abnormality that occurs in about 0.1 percent of the population and accounts for one to two percent of all strokes. Brain AVMs are formed at about eight weeks of gestation and consist of an abnormal connection of arteries to veins. This connection causes abnormal blood flow in and around the AVM, which increases the risk of stroke, bleeding, seizures, and other neurological problems.

arteriovenous malformation AVM
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How is an AVM diagnosed?

Brain AVMs usually are found between the ages of 10 and 40. The initial symptom typically falls into one of four categories: intracranial hemorrhage, seizure, headache and focal neurologic problems. Children are more likely to present with hemorrhage than adults. Brain AVMs are typically first discovered on a head CT or MRI of the brain, although the gold-standard blood vessels study (cerebral angiography) is required to plan treatment.

How are AVMs treated?

A number of factors are considered in the decision to treat AVMs and the therapy chosen. Surgery is the mainstay of treatment; radiosurgery is a useful option in brain AVMs in areas of the brain where surgery is high risk, and endovascular embolization (treatment through a catheter or tube placed into the blood vessels of the AVM) has become a useful add-on to these techniques.

arteriovenous malformation (AVM)What is a vein of Galen malformation?

A vein of Galen malformation (VOG) is an abnormal network of arteries and veins located deep within the brain. It places a varying amount of stress on the brain and other organ systems. Patients with this type of malformation can sometimes be diagnosed before birth. Others are discovered later in childhood. Early diagnosis is essential in order to preserve and protect neurologic function and organ development.

How is a VOG malformation diagnosed?

There are a variety of imaging techniques used to aide in diagnosis. Ultrasound in the prenatal period often demonstrates the first view of these lesions. Postnatal MRI and CT is also very helpful. Sometimes abnormalities in other organs systems lead to the diagnosis as children. For example, this malformation can present with heart, kidney, liver and lung problems. Once identified, a cerebral angiogram is often recommended for appropriate classification and treatment planning.

How is a VOG malformation treated?

When treatment is indicated, catheter based, or "endovascular," surgery is often used. The surgical approach to this type of malformation is usually tailored to individual patient anatomy. It is also important to recognize that some Vein of Galen malformations do not need surgical treatment and are observed usually with clinical and radiologic follow up.

At Monroe Carell Jr. Children's Hospital at Vanderbilt, we offer a comprehensive approach to the diagnosis and treatment of AVMs and VOGs. Through our multidisciplinary center, we provide resources for comprehensive treatment, long-term follow-up and support for patients and families.

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Last Edited: July 1, 2016
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