Medical Moment: A new surgery fixing leaking blood vessels in the brain

Published: Oct. 24, 2022 at 5:47 PM EDT
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(WNDU) - An AVM is an abnormal tangle of blood vessels in the brain. They form in less than one percent of the adult population, but still can be deadly.

One patient underwent successful surgery to remove his brain vessels leaking blood.

His only warning? A terrible headache.

A few months ago, Charles Hernandez started his day, but his head was killing him.

“I woke up with a severe headache on the right side,” Hernandez recalled.

Charles started the drive to work, and promptly slammed into a parked car.

“I saw it in front of me, but I couldn’t react, I couldn’t react,” Hernandez said.

In the ER, he couldn’t even tell doctors what happened. But brain scans brought the story to light.

“The doctor said that I had three aneurysms with bleeding in the brain,” Hernandez said.

“Well, he had an arterial venous malformation, which is an abnormal connection between arteries and veins inside the brain,” said Justin Mascitelli, MD, a vascular neurosurgeon at Baptist Health Systems San Antonio.

Aneurysms that can rupture and cause instant death.

When Dr. Mascitelli operated on Charles’s brain, the AVM was, fortunately, in an accessible place.

“His AVM was kind of on the top, in the back, and it was on the surface,” Dr. Mascitelli said. “We actually make an incision and use a microscope to go into the brain and actually remove the AVM.”

“Next thing I know, they are bringing me back to my bed,” Hernandez remembered.

Surprisingly, the procedure has few after-effects.

“We looked at each other, my wife and I, and tears were rolling down,” Hernandez said. “I think of the people that don’t survive or have other issues, so, I’m blessed.”

And he’s back to enjoying precious time with his wife and riding into his much brighter future.

Determining the optimal treatment strategy requires a detailed understanding of an AVM’s anatomy.

Mayo Clinic uses the latest imaging technology, including 3D modeling software and augmented reality visualization, to guide decision-making.

“When surgery is indicated, these imaging modalities help us to find a safe corridor and complete the surgery in an elegant fashion,” said Chandan Krishna, M.D., a neurosurgeon at Mayo Clinic’s campus in Arizona. “AVM is a pathology that requires not just one set of eyes, or clinicians working in silos, but a team approach.”

They occur throughout life, but the peak onset of symptoms is between 35 to 40 years of age.