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Vascular malformations of the brain
A guide for patients and carers
What is neurosurgery?
Neurosurgery is the longest established treatment for vascular malformations of the brain. It is usually used to treat AVMs of the brain, and sometimes AVMs of the dura and cavernous malformations. The decision about surgery will be based on the future risks of your condition, and how safe it is to remove the vascular malformation according to its location and size.
What happens before surgery?
You will be admitted to hospital at least one day before your surgery is scheduled. Normally your fitness for an anaesthetic will have been assessed with a thorough examination, blood tests, an x-ray of your chest and perhaps a recording of your heart rhythm. You will not be allowed to eat or drink for several hours before the operation. An anaesthetist will give you a general anaesthetic on the day of surgery, so you will be asleep before you are taken into the operating theatre.
What happens during surgery?
The team looking after you will include one or more surgeons, an anaesthetist and theatre nurses. Some of the hair on your head may need to be shaved. The surgeon will then create an opening in your skull, called a craniotomy, over the AVM. The AVM will then be carefully detached from the surrounding vessels, which may take several hours.
What will happen after surgery?
When the surgeon has finished, the opening made in your skull will be closed and covered with a dressing. You will then be taken to a recovery area, usually in the intensive care unit, where you will be observed closely. Shortly after you have woken up from the anaesthetic, you will be transferred back to the ward, and you can expect to leave the hospital within a week or two if there are no problems.
Epileptic seizures may occur for the first time, and if you have already
had them they may get better or worse. Some weeks or months after the operation, your doctors may want to repeat an angiogram or MRI scan to check how effective the surgery has been. You will need to convalesce at home for several weeks, and some people need physiotherapy in a rehabilitation unit. It is likely that you will need to take several weeks, and in some cases, several months off work after the operation.
As with any treatment, there are risks and benefits of surgery. It may be possible to completely remove your vascular malformation, which could protect you from developing other problems in the future. Surgery can sometimes be used to remove larger malformations, which would be too big for radiosurgery, or which could be only partially treated with embolisation. On the other hand, surgery requires a general anaesthetic, which has its own risks, and some deep malformations cannot be reached safely by surgery.
You will be admitted to hospital at least one day before your surgery is scheduled. Normally your fitness for an anaesthetic will have been assessed with a thorough examination, blood tests, an x-ray of your chest and perhaps a recording of your heart rhythm. You will not be allowed to eat or drink for several hours before the operation. An anaesthetist will give you a general anaesthetic on the day of surgery, so you will be asleep before you are taken into the operating theatre.
What happens during surgery?
The team looking after you will include one or more surgeons, an anaesthetist and theatre nurses. Some of the hair on your head may need to be shaved. The surgeon will then create an opening in your skull, called a craniotomy, over the AVM. The AVM will then be carefully detached from the surrounding vessels, which may take several hours.
What will happen after surgery?
When the surgeon has finished, the opening made in your skull will be closed and covered with a dressing. You will then be taken to a recovery area, usually in the intensive care unit, where you will be observed closely. Shortly after you have woken up from the anaesthetic, you will be transferred back to the ward, and you can expect to leave the hospital within a week or two if there are no problems.
Epileptic seizures may occur for the first time, and if you have already
had them they may get better or worse. Some weeks or months after the operation, your doctors may want to repeat an angiogram or MRI scan to check how effective the surgery has been. You will need to convalesce at home for several weeks, and some people need physiotherapy in a rehabilitation unit. It is likely that you will need to take several weeks, and in some cases, several months off work after the operation.
As with any treatment, there are risks and benefits of surgery. It may be possible to completely remove your vascular malformation, which could protect you from developing other problems in the future. Surgery can sometimes be used to remove larger malformations, which would be too big for radiosurgery, or which could be only partially treated with embolisation. On the other hand, surgery requires a general anaesthetic, which has its own risks, and some deep malformations cannot be reached safely by surgery.
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Page 12 of 15
Contents
- Introduction
- What is a vascular malformation of the brain?
- Arteriovenous malformation (AVM)
- Cavernous malformation
- Venous malformation
- What tests will the doctors do?
- What are the symptoms of a vascular malformation?
- What are the risks for the future?
- How can vascular malformations be treated?
- What is embolisation?
- What is stereotactic radiosurgery?
- What is neurosurgery?
- What other treatments might I have?
- How will my life be affected?
- Other organisations that may be able to help
