Stages of arteriovenous malformation
The arteriovenous malformation may be congenital but may be found later in life, depending on its location and size. It develops with one’s growth and becomes apparent as one reaches puberty or after an accident. Thus, AVM changes with time and grows in size. AVMs can be categorized into four classes using a scale called the Schobinger staging system, but not all AVMs pass through all the stages as per the scale.
The four stages are as follows:
Stage I or the quiescence stage: The word “quiescence” means “quiet or dormant.” In this stage, the AVM does not grow in size or exhibit any expansion. Instead, they remain “quiet” and asymptomatic. However, the area of skin near the AVM appears warm and pink.
Stage II or the expansion stage: In this stage, the AVM grows in size. One can even feel a pulse in the AVM during the expanding stage.
Stage III or the destruction stage: The AVM is aggressive and starts exhibiting complications in this stage. Pain, bleeding, and ulceration are a few general complications associated with a stage III AVM.
Stage IV or the decompensation stage: It is the last stage of AVM, often leading to heart failure.
Most AVMs are asymptomatic and do not show symptoms. Most AVMs are discovered during the diagnosis of other medical conditions and some during an autopsy after death. However, they grow bigger during pregnancy, adolescence, or after an injury and exert a high risk of bleeding.
Symptoms primarily depend on their locations. They are as follows:
The general symptoms of AVM other than bleeding are loss of neurocognition, nausea, headache, loss of consciousness, convulsions, fatigue, dizziness, dementia, confusion, and hallucination.
Muscle weakness and paralysis, loss of coordination, back pain, and numbness are other symptoms that characterize AVM.
In children, AVM causes learning problems and behavioral changes.
AVM or malformation of blood vessels in the brain leads to brain arteriovenous malformation.
Symptoms of brain AVM include seizures, dementia, and confusion. In addition, it often leads to cerebral stroke and congestive heart failure. Brain AVMs also often lead to excruciating headaches, difficulty in speech, vision loss, unsteadiness, and paralysis.
In particular, an entanglement in the vein of Galen, located deep inside the brain, can impose several deleterious effects. It causes blood vessels on the scalp to swell and leads to a condition known as hydrocephalus. Excess fluid builds up in the brain in hydrocephalus, which eventually exerts pressure and causes a seizure.
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