Arteriovenous malformations: pulmonary and cerebral presentations

Arteriovenous malformations (AVM) are congenital anomalies that affect the vascular structure and can occur in both the lung and the brain. The pathophysiology of AVM involves an abnormal deviation of arterial blood flow to the veins, bypassing the capillaries, which can cause hypoxemia, heart failure and other complications. Symptoms of pulmonary arteriovenous malformations (PAVM) include dyspnea, cyanosis, hemoptysis, and pulmonary embolism. Cerebral arteriovenous malformations (CVAM) can present symptoms such as seizures, headache, intracerebral hemorrhage and neurological deficits. As for epidemiology, the prevalence of PAVM is rare and occurs twice as often in women than in men, except in newborns, while ACVA is more common, with an estimated prevalence ranging from 1.12 to 1.42 cases per 100,000 people/year. Multiple factors, such as vascular abnormalities, molecular modifications and alterations in the flow of arteries and veins, significantly influence the development of AVMs. The diagnosis of AVM involves performing imaging tests, such as chest X-ray, computed tomography (CT) and nuclear magnetic resonance (NMR). The therapeutic approach to PVAM may involve arterial embolization or surgery, depending on the extent of the lesion. On the other hand, CVAM can be treated with endovascular embolization, surgery or radiotherapy, also depending on the characteristics of the lesion. Thus, with proper diagnosis and treatment, many patients can have a satisfactory quality of life and prevent serious complications. (author)