AVM: Recovering from Surgery

After AVM surgery is completed, the surgeon will talk with your family and friends. You'll wake up in a recovery area. Then you'll be moved to a special unit, often an ICU (Intensive Care Unit), where you can be closely monitored.

In the Hospital

If you're in pain, your nurses can give you medications to help. Special equipment may be used to monitor your condition and help you breathe. When you're able, you will be moved from the ICU to a hospital room. There, you will continue your recovery.

At Home

You may be able to go home as soon as you can walk, eat, and drink normally. You may have an office visit within a week or so after your surgery. At this time, any remaining stitches or staples may be removed. You can expect to meet with your surgeon several times during the first few months. You may also have follow-up imaging tests to ensure your AVM is stable.

When to Call the Doctor

Call your surgeon at once if you have any of the following:

• Increased drowsiness
  
• Ongoing nausea or vomiting
  
• Extreme headaches
  
• Seizure
  
• Shortness of breath
  
• Pain or swelling in a leg
  
• Increased muscle weakness
  
• Fever of 101°F (38.3°C) or greater
  
• Burning during urination
  
• Redness or drainage from the incision or an IV site
  

AVM: Preparing for Surgery

As you prepare for AVM surgery, you may be told to do some of the following:

• You may be asked to donate blood for your surgery. You may also be told to stop taking aspirin and other medications that thin the blood. If you smoke, you should stop now.
  
• Shortly before the day of your surgery, you will have a medical exam. This ensures that you are healthy enough for the procedure.
  
• If you take any daily medications, ask if you should take them the day of surgery.
  
• At least 8  hours before surgery, or as directed, stop eating and drinking.
  

The Day of Your Surgery

Be sure to arrive at the hospital on time. You may feel a bit nervous. Your healthcare team will try to answer all your questions and put you at ease. Just before surgery, you will be given general anesthesia to help you "sleep" through the surgery. At some point, an IV (intravenous) line will be placed in your arm. This can supply medication and fluids as needed. In some cases, part of your head will be shaved. This is done to decrease the risk of infection.

Risks of Surgery

As with any surgery, surgery to treat AVM has certain risks. These include:

• Seizure
  
• Infection
  
• Loss of memory; confusion
  
• Swelling or bleeding in the brain
  
• Blood clots
  
• Loss of sensation, including vision
  
• Weakness or paralysis
  
• Inability to speak
  
• Death
  

Treating an Arteriovenous Malformation (AVM)

It's important to get medical attention for an AVM as soon as possible. Often, immediate treatment may help avoid serious complications of some AVMs. Current surgical methods make treatment for AVM safer and more effective than ever. The goal of treatment is to stop the flow of blood within the AVM.

Surgery for AVM

Surgical resection removes the tangled blood vessels.

• Reaching the brain: The surgeon uses a procedure called craniotomy to reach the brain. During a craniotomy, small holes called burr holes are made in the skull. The bone between the holes is cut and lifted away. Finally, the surgeon opens the dura and exposes the brain.
  
• Removing the AVM: Once the surgeon has access to the AVM, the abnormal arteries and veins are removed. This redirects blood flow to normal vessels, preventing the AVM from bursting and leaking blood.
  
• Closing the skull: When the AVM has been removed, the dura covering the brain is closed. In most cases, the skull bone is put back. The skull bone can be held in place using one of several methods. Titanium clamps are often used, as they provide the most stability and cover the burr holes. After the clamps are in place, the skin incision is closed with stitches or staples.
  

Arteriovenous Malformation (AVM)

You have been told that you have an arteriovenous malformation (AVM). An AVM is an abnormal tangle of blood vessels within the brain. Over time, pressure can build up and the AVM can rupture (burst). If you have an AVM, you were probably born with it. But most people don't know they have one until a problem occurs. Signs of an AVM include bad headaches, blurred or double vision, and seizures (jerking movements that are out of your control).