Vascular Problems: Arteriovenous Malformations

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Guest: Dr. Aquilla “Quill” Turk – Radiology/Neuro Interventional

Host:  Dr. Linda Austin – Psychiatry

Dr. Linda Austin:  I’m Dr. Linda Austin.  I’m talking, today, with Dr. Quill Turk who is Associate Professor of Radiology and Neurosurgery and an interventional neuroradiologist, a radiologist specializing in the brain, here at MUSC.  Dr. Turk, let’s talk, if we can, about an entity that’s rather rare, certainly not heard of, arteriovenous malformation (AVM).  What, exactly, is and AVM?

Dr. Quill Turk:  An AVM is an arteriovenous malformation.  It’s an abnormal connection, or communication, between the arteries and the veins in the brain.  It’s not actually a direct connection.  It’s where the arteries come into an abnormal cluster of blood vessels that then rapidly drain out through the veins.  It’s something that, typically, people are born with.  However, it doesn’t often present until much later in life, with a variety of symptoms, from somebody having a bleeding episode related to the AVM, to headaches, seizures, or some other neurologic sequelae of the AVM.

Dr. Linda Austin:  I’m sure these AVMs can be very small.  How large can they get though?

Dr. Quill Turk:  AVMs can range anywhere from very small, several millimeters, to actually replacing the entire side of the brain, so there are different varieties.  There are many things that we look at with AVMs to determine what the significance of the AVM is.  Certainly, where it’s located, if it’s around a part of the brain that’s very critical, such as the part of the brain that we use for speech, the ability to talk, or the part of the brain that helps us use our arms and legs, or the ability to feel, sensate, with our arms and legs, the ability to see.  It really depends on where it’s located.  It depends on the size.  It depends on the blood vessels that bring blood to it as well the blood vessels that take blood away from it.

Dr. Linda Austin:  So, describe some more, if you could, some of the symptoms that start to occur when an AVM is beginning to cause problems.

Dr. Quill Turk:  It can really be a wide variety of things.  Most frequently are people presenting with headaches or seizures.  They get worked up and a vascular malformation is discovered.  Another common presentation is somebody comes in and they basically have an episode where they lose consciousness or they have a sudden onset of severe headache and they have a bleeding episode in their head, and that’s related to the AVM bleeding.

Dr. Linda Austin:  So, does the AVM actually rupture, like a stroke, potentially?

Dr. Quill Turk:  It can.  In general, the things that we look at, basically, are abnormal connections between arteries and veins, so it does not feed the normal brain and, therefore, some of the, what we call, compacitance are taken out so th

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