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How To Diagnose An AVM Or DAVF?

Posted on Tue, 17 Jun 2014

Question: What test is the absolute best way to diagnose an AVM or DAVF?

Answered by Dr. Sudhir Kumar (4 hours later)

Brief Answer:
4-vessel cerebral angiogram

Detailed Answer:
Hi,

Thank you for posting your query.

4-vessel cerebral angiogram is the best way to confirm the diagnosis of AVM (arterio-venous malformation) or DAVF (dural arterio-venous fistula).

I hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.

Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (5 hours later)

I thought I uploaded a pic for you to see- I am a nurse and this pic sure looks like a venous thrombosis to SSS and transverse with poss AVN or DAVF? What do you think?

Answered by Dr. Sudhir Kumar (3 hours later)

Brief Answer:
Difficult to be sure on that MRV picture

Detailed Answer:
Hi,

Thank you for getting back with more information.

I saw that MR venogram picture. I agree that transverse and sigmoid sinuses look hypoplastic (narrow) on one side, but it does not look like thrombosis. Also, I noted the increased venous channels in that region, but they could also be collateral vessels in cases of chronic venous thrombosis.

So, I agree with you that cerebral angiogram (with arterial and venous phases) is definitely required in this case to be sure of the diagnosis.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Sudhir Kumar (9 hours later)

Thank you for your answer ! I know this is definitely odd to try and diagnose online but the site is here and I have been suffering for 2 yrs so it's worth a shot. I do have another appt with a top notch Neuro Dr this coming Wednesday. I just wanted to be sure I understood what to ask for. When I hit the back of my head the initial Dr I saw said it's just a migraine. This is what I have just been diagnosed with:
1) pineal cyst 9x8 mm 2) displaced internal cerebral vein 3) 4mm herniation of cerebellum 4) tear right internal carotid artery 50% stenosis 5) avm/DAVF 6) aneurysmal vein of Galen . If the thrombosis is chronic at this point - I think is this is why the DAVF developed. I have been suffering with 3-8 occipital head pressure and a huge amount of quirky symptoms since then but the most difficult is the slowing of my thought processes and cognitive dysfunction. So... I am definetly asking for a cerebral angiogram.

Answered by Dr. Sudhir Kumar (56 minutes later)

Brief Answer:
I agree with your thoughts on this issue

Detailed Answer:
Thank you for getting back with more information.

I have seen a few cases of DAVF due to chronic cerebral venous thrombosis. I feel it would be worthwhile going for a cerebral angiography to prove or exclude that.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Yogesh D