Drs. Connolly and Solomon
Over the years these cerebrovascular specialists have authored a lot of journal articles, but this one is quite a feather in their cap; the NEJM is considered by many to be the most prestigious medical journal in the world.
The review article, titled Arteriovenous Malformations of the Brain, was published in May, and it serves up more than 50 years of combined knowledge on this complex blood vessel disorder.
An arteriovenous malformation (AVM) is a rare tangle of blood vessels that some people are born with. When it occurs in the brain it can be life threatening because it is at risk of causing a brain hemorrhage. It can also cause damage to the brain tissue around it. While many people never know they have an AVM until it ruptures, some experience headaches or seizures because of it.
In their review Drs. Solomon and Connolly discussed the condition, it’s risks and the various treatments, which include surgical removal, radiation, and plugging up of the malformation using minimally invasive endovascular techniques. Sometimes, they say, if treatment is too risky or the AVM is unlikely to cause damage, the best treatment may be to just watch and wait.
Each case is unique and these decisions depend on the size of the AVM, its location in the brain and its vascular structure. In the article the authors conclude, “The complexity of cerebral arteriovenous malformations calls for treatment by a collaborative team of physicians who can guide intervention for individual patients by considering the complete array of available treatment options.”
If you want to read the full article in the New England Journal of Medicine, you can access it online here with a subscription or pick up a copy of the May 2017 issue. Also, a story featuring Dr. Solomon’s AVM review and comments was posted on MedPage Today.
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