Malformación arteriovenosa (MAV)

Su médico comenzará preguntándole sobre su historial médico, especialmente sobre cualquier condición hereditaria que podría aumentar su riesgo de EAV. También querrá saber sobre los síntomas que ha experimentado, cuándo comenzaron, con qué frecuencia ocurrieron y cómo se sentían.

Durante el examen físico, su médico revisará su estado de salud general. Es posible que utilice un estetoscopio para escuchar un sonido en sus vasos sanguíneos llamado "ruido". Un ruido es un sonido de silbido que puede ocurrir cuando la sangre fluye a través de las arterias y venas más rápido de lo habitual, lo que puede suceder en personas con un EAV.

Varias pruebas de diagnóstico por imagen pueden ayudar a su médico a comprender la estructura y función de sus vasos sanguíneos y confirmar la presencia de un EAV. Estas pruebas incluyen:

• Cerebral angiography: This X-ray-based test involves injecting a contrast agent (dye) into an artery, which allows your blood vessels to show up clearly in the images. It provides detailed pictures of the AVM.
• Computed tomography (CT) scan: A CT scan uses X-rays to create 3D images and can help detect a brain or spinal cord bleed.
• Magnetic resonance imaging (MRI) scan: An MRI creates detailed images of the blood vessel defect and the surrounding organs and tissues.
• Magnetic resonance angiography (MRA) scan: This type of MRI focuses on blood flow and can show how well blood is moving through a vascular defect. A contrast dye may be used, but it’s not always necessary.
• Transcranial Doppler ultrasound: This test sends sound waves through your skull to produce images of the arteries. Doctors can use these images to identify blood vessel defects.

Aunque los medicamentos no pueden eliminar un AVM, pueden ayudarle a controlar los síntomas y mejorar su calidad de vida. Su médico puede prescribirle medicamentos como:

• Anti-seizure medications: These are for people who experience seizures, which can be a common symptom of AVMs. By controlling seizures, these medications help ensure your safety and allow you to continue participating in daily activities.
• Blood pressure medications: High blood pressure can increase the risk of an AVM rupturing. Medications that lower blood pressure can help reduce this risk, supporting better vascular health and preventing complications.
• Pain relievers: If you experience pain due to the AVM, such as headaches or discomfort, your doctor may recommend over-the-counter or prescription pain medications to provide relief and improve your overall comfort.

Su médico puede recomendarle una cirugía si el AVM está creciendo, corre el riesgo de romperse o está en una posición en la que sería fácil de extirpar sin un riesgo significativo de complicaciones. Las opciones quirúrgicas incluyen:

• AVM resection: This procedure involves removing the AVM through a small incision. To prevent bleeding during the procedure, nearby blood vessels are closed off. Once the AVM is removed, the surgeon reroutes blood flow through healthy arteries and veins. This approach can be highly effective for AVMs that are easily accessible and not too deeply embedded in the brain or spinal cord.
• Embolization: A surgeon will inject coils or a glue-like substance into the AVM. This material blocks blood flow to the group of tangled blood vessels, which causes the AVM to shrink over time. This approach is often used in combination with surgery to shrink the AVM before removal, making the surgery less complicated and safer.
• Radiosurgery: This treatment is often used for small AVMs that are hard to reach with traditional surgery. It uses focused radiation beams to precisely target the AVM. The radiation damages the blood vessels in the AVM, causing them to shrink and eventually close off. This process happens gradually, with the AVM shrinking over a period of months or even years. Since it’s noninvasive, radiosurgery can be an effective option for treating AVMs that are difficult to remove through surgery.