Arteriovenous malformation: Difference between revisions
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The result is a collection of blood vessels with abnormal connections and no [[Capillary|capillaries]]. This collection, often called a ''nidus'', can be extremely fragile and prone to bleeding. |
The result is a collection of blood vessels with abnormal connections and no [[Capillary|capillaries]]. This collection, often called a ''nidus'', can be extremely fragile and prone to bleeding. |
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Arteriovenous malformation can present in various locations: |
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* [[intercostal space]]<ref name="pmid17056881">{{cite journal |author=Rivera PP, Kole MK, Pelz DM, Gulka IB, McKenzie FN, Lownie SP |title=Congenital intercostal arteriovenous malformation |journal=AJR Am J Roentgenol |volume=187 |issue=5 |pages=W503–6 |year=2006 |month=November |pmid=17056881 |doi=10.2214/AJR.05.0367 |url=http://www.ajronline.org/cgi/pmidlookup?view=long&pmid=17056881}}</ref> |
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* [[Iris (anatomy)|iris]]<ref name="pmid16534057">{{cite journal |author=Shields JA, Streicher TF, Spirkova JH, Stubna M, Shields CL |title=Arteriovenous malformation of the iris in 14 cases |journal=Arch. Ophthalmol. |volume=124 |issue=3 |pages=370–5 |year=2006 |month=March |pmid=16534057 |doi=10.1001/archopht.124.3.370 |url=http://archopht.ama-assn.org/cgi/pmidlookup?view=long&pmid=16534057}}</ref> |
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* [[spermatic cord]]<ref name="pmid17939869">{{cite journal |author=Sountoulides P, Bantis A, Asouhidou I, Aggelonidou H |title=Arteriovenous malformation of the spermatic cord as the cause of acute scrotal pain: a case report |journal=J Med Case Reports |volume=1 |issue= |pages=110 |year=2007 |pmid=17939869 |doi=10.1186/1752-1947-1-110 |url=http://www.jmedicalcasereports.com/content/1//110}}</ref> |
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* [[pancreas]]<ref name="pmid">{{cite journal |author= |title= |journal= |volume= |issue= |pages= |year= |pmid= |doi= |url=http://joi.jlc.jst.go.jp/JST.JSTAGE/jnms/73.346?from=PubMed}}</ref> |
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* [[spinal cord]]<ref name="pmid15730991">{{cite journal |author=Kishi K, Shirai S, Sonomura T, Sato M |title=Selective conformal radiotherapy for arteriovenous malformation involving the spinal cord |journal=Br J Radiol |volume=78 |issue=927 |pages=252–4 |year=2005 |month=March |pmid=15730991 |doi= |url=http://bjr.birjournals.org/cgi/pmidlookup?view=long&pmid=15730991}}</ref> |
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==Presentation== |
==Presentation== |
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Revision as of 21:36, 1 June 2008
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- AVM is not to be confused with AMV.
| Arteriovenous malformation | |
|---|---|
| Specialty | Medical genetics, neurosurgery  |
Arteriovenous malformation or AVM 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.
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 high pressure arteries to the low pressure veins.
If the capillary bed is thought of as a sponge, then an AVM is the rough equivalent of jamming a tangle of flexible soda straws from artery to vein through that sponge. On arteriogram films AVM formation often resemble a tangle of spaghetti noodles. This tangle of blood vessels forms a relatively direct connection between high pressure arteries and low pressure veins.
The result is a collection of blood vessels with abnormal connections and no capillaries. This collection, often called a nidus, can be extremely fragile and prone to bleeding.
Arteriovenous malformation can present in various locations:
Presentation
AVMs can occur in various parts of the body including the brain (see cerebral arteriovenous malformation), spleen, lung, kidney, spinal column, and liver. AVMs may occur in isolation or as a part of another disease (e.g. Von Hippel-Lindau disease or hereditary hemorrhagic telangiectasia).
This bleeding can be devastating, particularly in the brain. It can cause severe and often fatal strokes. If detected before a stroke occurs, usually the arteries feeding blood into the nidus can be closed off, ensuring the safety of the patient.
Noteworthy cases
- On December 13, 2006, Senator Tim Johnson was diagnosed with AVM and treated at George Washington University Hospital.[6]
- Stuart Sutcliffe, the Beatles' original bassist, died of a brain hemorrhage in 1962. It was originally thought to have been caused by blows to the head during various scuffles in seedy sections of Liverpool, but it is now believed to have been caused by AVM.[citation needed]
- A.J. Price, a point guard on the University of Connecticut Men's Basketball team was diagnosed with AVM in 2004 and was treated with a series of radiosurgeries
Cases in fiction
- The plot of William Finn's 1998 Off-Broadway musical, A New Brain, revolves around the main character's battle with AVM.
- The character Nate Fisher on the HBO television show Six Feet Under suffers from AVM.
- An episode of the television sit-com Becker used a cerebral AVM as a plot device.
- The character John Henry Giles, a fictional jazz legend from the series "House", was eventually diagnosed with AVM in the episode DNR.
- Furthermore, House's patient in Top Secret has AVM due to HHT.
- An episode of Grey's Anatomy season 1 episode 9, the 'psychic' who is thought to have visions, actually has cerebral AVM.
- In Robert J. Sawyer's novel Mindscan, the protagonist has an inherited condition called Katerinsky's syndrome which increases one's risk of having an AVM, which causes him to upload his consciousness to a robot earlier than normal.
In the Media
- The Who Had Minutes To Live was a documentary made of AVM sufferer Pete Nash. It follows him as he raises money for his operation that will save his life. He was forced to raise money after the NHS refused to undertake the operation.
References
- ^ Rivera PP, Kole MK, Pelz DM, Gulka IB, McKenzie FN, Lownie SP (2006). "Congenital intercostal arteriovenous malformation". AJR Am J Roentgenol. 187 (5): W503–6. doi:10.2214/AJR.05.0367. PMID 17056881.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ Shields JA, Streicher TF, Spirkova JH, Stubna M, Shields CL (2006). "Arteriovenous malformation of the iris in 14 cases". Arch. Ophthalmol. 124 (3): 370–5. doi:10.1001/archopht.124.3.370. PMID 16534057.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ Sountoulides P, Bantis A, Asouhidou I, Aggelonidou H (2007). "Arteriovenous malformation of the spermatic cord as the cause of acute scrotal pain: a case report". J Med Case Reports. 1: 110. doi:10.1186/1752-1947-1-110. PMID 17939869.
{{cite journal}}: CS1 maint: multiple names: authors list (link) CS1 maint: unflagged free DOI (link) - ^ http://joi.jlc.jst.go.jp/JST.JSTAGE/jnms/73.346?from=PubMed.
{{cite journal}}: Cite journal requires|journal=(help); Missing or empty|title=(help) - ^ Kishi K, Shirai S, Sonomura T, Sato M (2005). "Selective conformal radiotherapy for arteriovenous malformation involving the spinal cord". Br J Radiol. 78 (927): 252–4. PMID 15730991.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ "Sen. Johnson recovering after brain surgery", AP, December 14, 2006.
External links
- Information about arteriovenous malformations from the Children's Hospital, Seattle.
- Information from the AVM Foundation (USA)
- Information from the AVM Support UK
- Information from AVM Support
- avms at NINDS