Arteriovenous Malformation (AVM) is a tangle of arteries and veins which are directed connected to each other instead of the capillaries in between. Arteries carry oxygenated blood to all parts of the body with great flow. This blood passes from the arteries into thin capillaries where the blood flow is greatly reduced. The walls of the capillaries are porous and they supply oxygen to the surrounding brain tissue through these porous walls. In AVM these capillaries are bypassed and thus oxygen supply to the brain tissue is reduced. This causes damage to the brain. The high pressure of the blood moving from the arteries into the veins can weaken the walls of the blood vessels and can result in either a haemorrhage or the formation of an aneurysm.
AVM's are mostly present at the time of birth but do not cause any symptoms during the early childhood and therefore go unnoticed. The AVM's are mostly diagnosed accidently when the brain scan is done for any other problem. They symptoms of AVM can include headache, seizures, muscle weakness, vision loss, body imbalance etc.
Cerebral Angiography which is done on a Cathlab is the best test to diagnose AVM. The test reveals the location and characterstics of the feeding arteries and draining veins which helps in planning the treatment. In this test the neurosurgeon will insert a catheter into the femoral artery of your leg and move the catheter into the brain inside the artery using the cathlab images for guidance. Alternatively a CT Scan or better still an MRI can provide excellent information and that too without admitting to the hospital. Both CT Scan and MRI are non-invasive procedures unlike Cerebral Angiography.
The treatment for AVM is to surgically remove the interconnected arteries and veins. If the AVM is located in a part of the brain which can be easily accessed by the neurosurgeon then this type of surgery is the preferred option. However if the AVM is located deep inside the brain then endovascular coiling is a better option. In this the surgeon will use a catheter which is inserted through the femoral artery on the leg and then coils are used to block the passage between the arteries and the veins. Stereotactic Radiosurgery in which focused radiation is used to block the connection between the arteries and veins is a non invasive treatment option.
Max Hospitals at New Delhi and Gurgaon have the most advanced cutting edge technology when it comes to AVM Surgery. The operation theatres are equipped with very high precision Operating Microscopes from Karl Storz, Germany. For endovascular coiling we have the most advanced Cath Lab and for Stereotactic Surgery we use the latest Linear Accelerator with IGRT and IMRT. The technology deployed at Max Hospital in the field of Neurosurgery makes us the premier centre in the world. India offers huge advantages in terms of cost of treatment, cost of hotels, food and travel.
The cost of diagnosing AVM would be in the range of USD 1000 - 1500 while the cost of AVM Surgery would be USD 6000 - 8000. The cost of Endovascular Coiling would be in the range of USD 6000 - 12000 depending upon the number of coils used in the treatment. The cost of Stereotactic Surgery would be USD 7000 for a package of 10 sittings.
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Dr. Arun Saroha
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Dr Arun Saroha is one of the most trusted doctor amongst the Iraqi patients who have been coming to him for the treatment of brain ans apine problems for the last 15 years. Lots of hard work and dedication has gone in the building of this trust.