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Arteriovenous Malformation (AVM)

What is Arteriovenous Malformation?

An arteriovenous malformation (AVM) is a group of blood vessels that didn’t form properly and have become intertwined, which impedes the blood flow. When they’re cut, these veins and arteries tend to bleed faster than normal veins due to the pressure of being tangled together.

The most common place for an AVM is in the brain. The arteriovenous malformation circumvents the brain tissue and reroutes the flow of blood between the arteries and the veins. This results in the arteries delivering less oxygen to the brain, and the veins returning blood with less oxygen to the heart. They can happen anywhere in the brain. Less than one percent of the U.S. population has an AVM.

Arteriovenous Malformation Causes

The cause of an AVM is somewhat of a mystery. There have been cases where they develop while a child is developing in the womb or during childhood. This leads some doctors to believe that the cause can be genetic. Other causes could be as a result of a complication from surgery or due to a trauma. Unfortunately, there is not a clear cause for this condition.

Arteriovenous Malformation Symptoms

Symptoms vary based on the type of arteriovenous malformation. Most types don’t present any symptoms, though general symptoms may include seizures and migraines. Unfortunately, if there are other symptoms aside from migraines and seizures, that typically means that there’s already a bleed. However, common arteriovenous malformation symptoms amongst the different types may include:

  • Swelling where the intertwined blood vessels are located
  • Ringing in the ears
  • Ulcers/lesions
  • External bleeding
  • Pain where the intertwined blood vessels are located

Other symptoms may occur depending on the type.

Types of Arteriovenous Malformation

Brain AVM

A brain arteriovenous malformation occurs as a baby is developing inside the mother’s womb. It is not believed to be caused by genetics, but there are certain risk factors that raise the odds of having one. Females are less likely than males to have an AVM.

Most symptoms occur before the age of 50. After that, an AVM tends to stabilize. Women may notice symptoms during pregnancy due to increased blood flow. Usually, there are no symptoms until there is a rupture. Symptoms may include any of the following.

  • Sudden severe headaches
  • Nausea or vomiting
  • A pulsation in your head
  • Seizures
  • Fainting
  • Speech problems
  • Inability to understand other people
  • Weakness, numbness or paralysis in extremities
  • A swooshing noise that can be heard with a stethoscope

Seizures and bleeding within the brain might cause a stroke or brain damage, which could result in permanent paralysis as well as loss of memory, speech, and vision.

Capillary AVM

Capillary arteriovenous malformation occurs when there’s a malformation of the tiny blood vessels that connect the arteries and veins called capillaries. The malformation is due to swollen capillaries below the surface of the skin. These small pink or red bumps can appear on the face, arms, and/or legs. There are individuals that have capillary malformations without having an AVM. However, to be diagnosed with this particular type of condition, the individual has to have an arteriovenous malformation in addition to capillary malformations.

In addition to the presence of the enlarged capillaries, other symptoms may include:

  • Irregular bleeding
  • Migraines
  • Seizures
  • Heart failure

This condition can develop at birth or during childhood and is hereditary. It is believed to be caused by a genetic mutation.

Dural Sinus AVM

Dural sinus arteriovenous malformation occurs in the brain. There’s a thick, leather-like membrane that covers the brain and spinal cord called dura mater, which is where this condition gets its name. When there are abnormalities with the vessels found in the dura mater, dural sinus AVM is typically the culprit. Symptoms that come with this condition can include:

  • Tinnitus (ringing in the ears)
  • Headaches
  • Blurred vision
  • Seizures
  • Bleeding

Some individuals may have this type without experiencing any symptoms. It is believed that most people get this type after brain surgery. It’s not genetic nor is it cancer. The diagnosis of this condition is typically done through an x-ray of the brain. A diagnosis will be given if a patient is experiencing neurological issues, debilitating symptoms, or experienced bleeding.

Facial AVM

Facial arteriovenous malformation is characterized by swelling or ulcers found on the face. The abnormal blood vessels impede the natural blood flow in the face, which causes the swollen appearance or lesions. The swelling or ulcers may be painful for some, but others may not feel any pain. Other symptoms may include:

  • Ringing in the ears
  • Blurred vision
  • Headaches
  • Difficulty with speech
  • Trouble with breathing
  • Difficulty swallowing
  • Bleeding

Facial AVMs can occur during childbirth or can form in adulthood. The abnormal blood vessels can come and go. A series of tests will need to be run in order to get an accurate diagnosis. These tests can include ultrasounds and angiograms.

Frontonasal AVM

Frontonasal arteriovenous malformation occurs when abnormal blood vessels form in the frontonasal area. Symptoms can include:

  • Nasal bleeds
  • Blurred vision
  • Swelling
  • Ulcers
  • Pain
  • Heart failure

Mandibular AVM

Mandibular arteriovenous malformation occurs along the jaw bone, or mandible. Since the AVM happens along the jaw bone, the teeth and gums can also be affected. Some symptoms may include:

  • Bleeding of the gums
  • Loose teeth
  • Numbness in the lower lip
  • Swelling of the face

If any teeth have to be surgically removed, life-threatening bleeding may occur. MRIs or x-rays can help doctors diagnose this type.

Maxillary AVM

Maxillary arteriovenous malformation is similar to facial and mandibular AVMs as all three occur on the face. The differences between the three are that facial AVMs appear below the skin, mandibular AVMs occur on the lower jaw bone, and maxillary AVMs can occur anywhere on the face including the upper set of teeth. Symptoms are very similar for all three and may include:

  • Swelling of the face
  • Loose teeth
  • Bleeding gums
  • Painful ulcers in the mouth
  • Headaches

This condition typically comes with painful lesions that bleed when touched. Several tests may be necessary to diagnose this type including biopsies of the lesions.

Pulmonary AVM

Pulmonary arteriovenous malformation occurs when the blood flow to the heart and the lungs have an abnormal connection. Symptoms may not be present, but if they are they may include:

  • Difficulty breathing
  • Various types of bleeding (through the nose, from the lungs, etc)
  • Stroke

This type can develop in the womb, after birth, or as a result of a trauma or surgery.

The severity of these conditions depends on the location of the AVM.

Arteriovenous Malformation Diagnosis

Most AVMs can be diagnosed with various tests. These tests are mainly MRIs and angiograms, but can also include CT scans, MRAs (magnetic resonance angiograms), and x-rays. Several tests may need to be run in order to properly diagnose the type of arteriovenous malformation. For the types with lesions, biopsies may be necessary to rule out other conditions.

Is arteriovenous malformation life threatening?

While it’s possible for people diagnosed with this condition to live a long life, there is a risk of fatal hemorrhaging. Since most of the types of arteriovenous malformations have the possibility of bleeding, there is also the possibility of losing enough blood that it’s considered life-threatening. Keep in mind, however, that preventative measures can be taken to ensure hemorrhaging does not occur.

Arteriovenous Malformation Prognosis

The prognosis of an arteriovenous malformation is hard to predict as there’s a chance for hemorrhaging. If doctors are able to prevent a hemorrhage from happening or can treat a life-threatening bleed, the prognosis becomes better as there is less chance of a fatality. To put things in a better perspective, the prognosis for an AVM is better than the prognosis for a brain aneurysm since doctors have the chance to prevent a rupture from occurring.

Arteriovenous Malformation Treatment

Since there isn’t a cure, treatment is mainly focused on preventing hemorrhaging and treating symptoms. Certain medications may work well as a preventative treatment. Most medication that doctors will prescribe will typically be focused on pain management and seizure prevention.

Can an AVM be removed?

If the severity of the arteriovenous malformation is bad, doctors may result in surgery as a treatment option to remove the damaged blood vessels or repair them, if possible.

Getting SSDI for Arteriovenous Malformation

An AVM can disrupt your life by causing wide mood swings and making you unable to carry on with your employment. A stroke caused by an arteriovenous malformation can partially or completely immobilize you. If you or a loved one is suffering the symptoms of a brain AVM, you may qualify for financial aid from Social Security Disability Insurance (SSDI).

To qualify for SSDI, you must have a major health condition that has lasted for at least one calendar year and has rendered you unfit to continue your employment. You must have worked previously and earned enough work credits to qualify for Social Security Disability Insurance.

If you apply for SSDI, the first thing the Social Security Administration will do is check to see if your condition is on their list of impairments. This is a listing of conditions and side effects that the SSA deems to be automatically disabling. Should your condition not be on the impairment list, the SSA will use a medical vocational allowance to determine if you are able to work. While arteriovenous malformations are not on the list, you may qualify for SSDI if you had seizures that resulted in a loss of neurological functions.

If your condition does not meet the SSA’s requirements, you could still be eligible for SSDI assistance. To qualify, you must supply medical records documenting that you would be unable to continue your past employment or current employment and that you are unable to retrain for a new career. Older claimants have a better chance of proving this.

Getting Help from an Attorney

If you or a loved one has already petitioned the Social Security Administration for benefits, you may have already been denied assistance. In that case, you should find a qualified disability attorney to help you file an appeal. Claimants with legal representation are more likely to have the original decision overturned.

To discuss SSD and SSI claims or appeals, please call us at (215) 464-7200 or email the attorneys of Chermol & Fishman, LLC. The initial consultation is free, and we never charge a fee until we win your case.