Brain Arteriovenous Malformation Repair: Before Your Surgery

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What is a brain arteriovenous malformation surgery?

A brain arteriovenous malformation repair is a type of surgery. It removes a group of tangled blood vessels. This is called an arteriovenous malformation or AVM. The blood vessels in an AVM may get weak and leak or burst. This can make the tissue near it bleed.

An AVM can happen in many areas of the body. But it is often found in the brain. An AVM in the brain may cause seizures.

Before the surgery, you will go to the hospital to have an angiogram of your head. This is a type of X-ray test. It uses a special dye and camera to take pictures of blood flow in the blood vessels of your head. At this time, you may also have a procedure called AVM embolization. It sends tiny particles or a glue-like liquid into the AVM to block blood flow to it. This can make it easier for the doctor to remove the AVM during your surgery.

To do the surgery, the doctor will make a cut in your scalp. This cut is called an incision. Then the doctor may take out a part of your skull bone to be able to reach your brain. The doctor stops blood flow to the AVM and then removes it.

After the AVM is removed, the doctor may use small metal plates and clamps to put back the piece of your skull. Then the doctor closes the incision with stitches or staples.

You may stay in the hospital for a few days.

How do you prepare for surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
    Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
    Do not shave the surgical site yourself.
    Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
    The area for surgery is often marked to make sure there are no errors.
    You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
    When you are asleep, a doctor or nurse will shave part of your scalp. This is where the incision will be made.
    The surgery usually takes 1 to 4 hours. But in some cases it could take up to 12 hours.
    You may need to have another angiogram of your head. This is to see if the AVM was completely removed.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.