Arteriovenous Malformation Resection

Why is this surgery done?

Arteriovenous malformations (AVM) occur when blood vessels are abnormally tangled. AVMs can occur in many parts of the body, but Goodman Campbell treats those that appear in the brain or spine. Some AVMs appear to have no symptoms and therefore pose little risk. These AVMs are usually treated conservatively and watched.  When AVMs bleed, however, they can cause life threatening conditions. In these cases, surgery may be recommended, depending on the type, symptoms and location of the AVM.

AVMs typically do not show symptoms until a bleed occurs. Common signs of brain AVMs include severe headache, vomiting, stiff neck, seizures and ringing in an ear.

How is arteriovenous malformation resection done?

The neurosurgeon will evaluate the patient to determine if there has been a hemorrhage or bleed. If there is no bleeding, observation or medical treatment may be recommended. However, if there are signs of previous hemorrhage, the neurosurgeon will likely recommend either open surgery with a craniotomy , targeted radiation through radiosurgery , or minimally invasive endovascular embolization surgery to repair the blood vessel and stop the bleeding. 

What are my risks? What are common complications?

If an AVM does hemorrhage or bleed, there is a risk of permanent neurological injury.  

Surgery also has some risks. Like with any operation, there is a small risk for such things as infection, blood clot and even death. The risk specifically associated with this surgery is related to the fact that the operation is being performed on arteries and veins in your brain.

What do I need to know before surgery?

Tests such as MRI , CT scans and angiography are used to help determine the AVM’s location, size, type and involvement with other structures.

General discharge instructions

An anti-seizure medication may be used as a precaution during the first seven days following your operation.

  • Do not drive a car, use dangerous machinery, perform vigorous exercise or return to work until you are cleared by your surgeon.
  • Use common sense. Try to maintain some level of activity. This is better than staying in bed. Walking is generally a good idea, but don’t overdo it.
  • Wear a loose hat or head covering to keep sun off your incision for several months.
  • Don’t scratch your incision. You may use a gentle shampoo and clean it gently using the palm of your hand.
  • Avoid alcohol and recreational drugs.
  • Do not smoke: Smoking can delay healing and may contribute to postoperative infection.
  • Try to maintain a regular sleep schedule.
  • Pay attention to good hydration and nutrition.
  • Use stool softeners if needed.

When to call:

  • Fever of 101°F or higher
  • Wound drainage, redness or swelling at the incision site
  • Severe headache not controlled by pain medicine
  • Headache associated with vomiting, neck stiffness or light sensitivity
  • Confusion, trouble speaking or moving or any type of seizure activity

What should I expect while recovering?

When you are awake, you will usually resume a regular diet. You may have a mild sore throat from the breathing tube used during your general anesthesia. You most likely will get out of bed and sit in a chair the morning following your operation. Your urinary catheter and some of your IVs or monitoring lines will be removed. You may then start walking. Early on, the nurses will instruct you and be with you for any activity. You will usually transfer out of the ICU to a regular room within 1 – 2 days of your surgery.  

If a small surgical drain is placed under the scalp, it is removed within 1 – 2 days. If the incision is just behind your hairline, you may develop some swelling of your eyelid that may last for a few days after the drain is removed. Your surgical staples or sutures are usually left in place for 7 – 14 days.

You may have discomfort in your incision region, and you may have a headache. It usually is not severe. Medicine will be available to help if you need it. An area of your scalp may feel numb. This usually fades away over several months.

Following general anesthesia and surgery, you can expect to feel fatigued or tired in the first week to month following your discharge.  Your surgeon will limit activity as outlined in your discharge instructions.

If you had surgery because your AVM bled, your treatment process and recovery will mostly be dictated by the effects of the hemorrhage.


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