AVM: Surgery Fixes Leaking Blood Vessels in the Brain


SAN ANTONIO, Texas (Ivanhoe Newswire) – An AVM is an abnormal tangle of blood vessels in the brain. They form in less than one percent of the adult population, but still, can be deadly. This is the story of an AVM patient, who underwent successful surgery to remove his brain vessels leaking blood. His only warning? A very bad headache.

A few months ago, Charles Hernandez was starting his day, but his head was killing him.

“I woke up with a severe headache on the right side,” he explains.

Charles started the drive to work, and promptly slammed into a parked car.

He expresses, “I saw it in front of me, but I couldn’t react.”

In the E.R., he couldn’t even tell doctors what happened, but brain scans brought the story to light.

“The doctor said that I had three aneurysms with bleeding in the brain,” Charles tells Ivanhoe.

Vascular neurosurgeon at Baptist Health System in San Antonio, Texas, Justin Mascitelli, MD, explains, “Charles had an arterial venous malformation, which is an abnormal connection between arteries and veins inside the brain. On the arteries that were feeding the malformation, they had developed aneurysms over time.”

Those kinds of aneurysms can rupture and cause instant death. When Dr. Mascitelli operated on Charles’s brain, the AVM was, fortunately, in an accessible place.

“His AVM was on the top, in the back, and it was on the surface. We make an incision and use a microscope to go into the brain and remove the AVM,” Dr. Mascitelli demonstrates.

“Next thing I know, they are bringing me back to my bed,” Charles says.

He recovered with surprisingly few after affects.

Charles expresses, “We looked at each other, my wife and I, and tears were rolling down. I think of the people that don’t survive or have other issues, so, I’m blessed.”

Doctors say a headache from an AVM or aneurysm is one like you’ve never experienced before. If you or a loved one have those symptoms, head to the E.R. right away. Time is critical for treatment.

Contributors to this news report include Donna Parker, Producer; Bruce Maniscalco, Videographer; Roque Correa, Editor.

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REPORT:       MB #5127

BACKGROUND: An arteriovenous malformation (AVM) is an abnormal tangle of blood vessels connecting arteries and veins, which disrupts normal blood flow and oxygen circulation. Arteries are responsible for taking oxygen-rich blood from the heart to the brain. Veins carry the oxygen-depleted blood back to the lungs and heart. When an AVM disrupts this critical process, the surrounding tissues may not get enough oxygen. AVM affects males and females in equal numbers. The best estimates for new detection of an AVM are one per 100,000 population per year (about 3,000 new cases detected per year in the U.S.) The population prevalence is about 10 per 100,000, i.e., there are probably about 30,000 individuals in the U.S. who harbor an AVM or have had an AVM that was treated. They occur throughout life, but the peak onset of symptoms is 35-40 years of age.

(Sources: https://www.mayoclinic.org/diseases-conditions/arteriovenous-malformation/symptoms-causes/syc-20350544#:~:text=An%20arteriovenous%20malformation%20(AVM)%20is,to%20the%20lungs%20and%20heart.


DIAGNOSING: You may or may not have symptoms if you have an arteriovenous malformation. Up to 15% of people with AVMs don’t have symptoms. Often, the first sign you have an AVM is after it bleeds. AVMs can also irritate the surrounding tissue, causing neurologic symptoms, including seizures with or without loss of consciousness, headache, muscle weakness or complete paralysis, nausea and vomiting, numbness, or tingling sensation, and/or problems with movement, speech, memory, thinking, balance, or vision. Imaging tests used to detect arteriovenous malformations include an MRI, computed tomography, catheter angiography, or an ultrasound.

(Source: https://my.clevelandclinic.org/health/diseases/16755-arteriovenous-malformation-avm)

NEW TECHNOLOGY: Determining the optimal treatment strategy requires detailed understanding of an AVM’s anatomy. Mayo Clinic uses the latest imaging technology, including 3D modeling software and augmented reality visualization, to guide decision-making. “When surgery is indicated, these imaging modalities help us to find a safe corridor and complete the surgery in an elegant fashion,” says Chandan Krishna, M.D., a neurosurgeon at Mayo Clinic’s campus in Arizona. “AVM is a pathology that requires not just one set of eyes, or clinicians working in silos, but a team approach.”



Natalie Gutierrez

(210) 260-7250


If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com