Many patients who are diagnosed with an arteriovenous malformation (AVM) only find out about their condition in the emergency room after a rupture. Others are diagnosed when the AVM is seen on a CT scan or MRI, which may have been performed after an accident or injury or may have been ordered by a neurologist to investigate the cause of a patient’s headaches or other symptoms.
Computerized tomography (CT) and magnetic resonance imaging (MRI) scans are noninvasive procedures that produce images of brain or spine structures and detect bleeding. CT scans use X-rays and MRI scans use magnetic fields to create images of the brain or spine. CT and MR scans detect the AVM but are not precise enough to see the details of an AVM’s structure and location, which are best seen on cerebral angiography (angiogram).
Cerebral angiography, also called cerebral arteriography, is a minimally invasive procedure that provides a detailed image of blood flow in the brain. An angiogram is the gold standard for diagnosing and evaluating AVMs. To perform an angiogram, a specialist called an interventional neuroradiologist inserts a catheter (a small plastic tube) into a blood vessel and feeds it gently toward the location of the suspected AVM. A special dye called a contrast agent is injected through the catheter and makes its way to the malformation. The path of the contrast agent, when viewed on an X-ray, produces an image of the AVM’s structure and allows the neuroradiologist and neurosurgeon to locate the AVM precisely within the brain or spinal column.
The recommended treatment plan will be based not only on the angiogram but also on the patient's clinical history, age, symptoms, and a physical examination. For example, an older patient at low risk for bleed might be advised to have the AVM monitored rather than treated. Treatments include several surgical options (see Surgery for an AVM).
Use our online form to request an appointment with one of our cerebrovascular neurosurgeons, who have advanced expertise in treating AVMs and other vascular conditions of the brain and spine.
Reviewed by: Justin Schwarz, MD
Last reviewed/last updated: August 2021