Arteriovenous malformations overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]
Overview
Arteriovenous malformation is a congenital disorder of the connections between veins and arteries in the vascular system. The genetic transmission patterns of AVM (if any) are unknown, and AVM is not generally thought to be an inherited disorder--unless in the context of a specific hereditary syndrome.
Historical Perspective
Emmanuel, Luschka and Virchow first described arteriovenous malformations in the mid-1800s. Olivecrona performed the first surgical excision of an intracranial AVM in 1932.
Pathophysiology
Arteries and veins are part of the human cardiovascular system. Normally, the arteries in the vascular system carry oxygen-rich blood at a relatively high pressure. Structurally, arteries divide and sub-divide repeatedly, eventually forming a sponge-like capillary bed. Blood moves through the capillaries, giving up oxygen and taking up waste products from the surrounding cells. Capillaries successively join together, one upon the other, to form the veins that carry blood away at a relatively low pressure. The heart acts to pump blood from the low pressure veins to the high pressure arteries.
Epidemiology and Demographics
An estimated 300,000 people in the US have AVMs, of which 12% (approximately 36,000) will exhibit symptoms that differ greatly in severity.
Diagnosis
Symptoms
Symptoms of AVM vary according to the location of the malformation. Roughly (88% -needs citation) AVM are asymptomatic; often the malformation is discovered as part of an autopsy or during treatment of an unrelated disorder (called in medicine an incidental finding), rarely its expansion or a micro-bleed from it, could cause epilepsy, deficit or elicit pain.