Brain Arteriovenous Malformation Repair: What to Expect at Home

Your Recovery

A brain arteriovenous malformation repair is surgery to remove a tangled bunch of blood vessels, called an arteriovenous malformation (AVM). The doctor removed the AVM through a cut (incision) in your scalp and the bone surrounding your brain (the skull).

The incision in your scalp may be sore for about a week after surgery. You may also have numbness near the incision, or swelling and bruising around your eyes. The incision may itch as it starts to heal. Medicine and ice packs can help with headaches, pain, swelling, and itching. You may feel more tired than usual for several weeks.

You may be able to do many of your usual activities after 4 to 6 weeks. But you will probably need 2 to 6 months to fully recover.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

• Rest when you feel tired. You may feel sleepy more often than you did before the surgery. Plan to take a nap every day. Getting enough sleep will help you recover.
• When you sit up after lying down, bring your head up slowly. This can prevent headaches or dizziness.
• Be as active as you can. It can help prevent problems and help you recover. Walking is a good option for many.
• Allow your body to heal. Don't move quickly or lift anything heavy until you are feeling better.
• Do not play any rough or contact sports until your doctor says it is okay.
• You can wash your hair 2 to 3 days after your surgery. But do not soak your head or swim for 2 to 3 weeks.
• You will probably need to take at least 6 weeks off from work. It depends on the type of work you do and how you feel.

Diet

• You can eat your normal diet.
• Follow your doctor's instructions about drinking fluids.
• If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water, unless your doctor tells you not to. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• You may get medicines to prevent seizures and brain swelling. Take them exactly as directed by your doctor.
• Be safe with medicines. Read and follow all instructions on the label.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If you have strips of tape on the incision, leave the tape on until it falls off.
• Wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing. You may cover the area with a gauze bandage. Change the bandage every day.
• Keep the area clean and dry.

Ice and elevation

• For the first 1 to 2 days, you can use ice to reduce pain, swelling, and itching. Put ice or a cold pack on your head for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
• Try not to lie flat when you rest or sleep. You can use a wedge pillow, or put a rolled towel or foam padding under your pillow.

Rehabilitation

• Your doctor may recommend that you work with a speech therapist or occupational therapist if the surgery affected your speech or your ability to do your daily activities.

Other instructions

• Do not use an enema or laxative unless your doctor says it is okay.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and contact your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You passed out (lost consciousness).
• You have sudden chest pain and shortness of breath, or you cough up blood.
• You have severe trouble breathing.
• You have symptoms of a stroke. These may include:
  • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
  • Sudden vision changes.
  • Sudden trouble speaking.
  • Sudden confusion or trouble understanding simple statements.
  • Sudden problems with walking or balance.
  • A sudden, severe headache that is different from past headaches.
• Your body is jerking or shaking.
• You feel very sleepy.

Contact your doctor now or seek immediate medical care if:

• You fall and hit your head.
• You have a fever with a stiff neck or a severe headache.
• You have new or worse headaches.
• You are sick to your stomach or cannot keep fluids down.
• You have pain that does not get better after you take pain medicine.
• You have loose stitches, or your incision comes open.
• Bright red blood has soaked through the bandage over your incision.
• You have symptoms of infection, such as:
  • Increased pain, swelling, warmth, or redness.
  • Red streaks leading from the incision.
  • Pus draining from the incision.
  • A fever.
• Your incision leaks fluid, or fluid builds up under your scalp near the incision.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.