Introduction
It is a rare condition in which the small blood vessels connecting the arteries and veins in brain becomes messy. Arteries carry fresh blood to the cells and veins transports impure blood away from them. When an AVM develops, this system got damaged due to lack of connecting blood vessels between arteries and veins and thus the transport of blood is disrupted. The cause of AVM is not known. In most cases it develops in foetal stage itself. Rarely it spreads in families. It may appear anywhere in body but brain and spine are the common locations. Most of the time, there may not be any symptoms and hence it is often diagnosed accidently during an imaging test of brain or following a haemorrhage.
Signs and symptoms vary according to the patient’s condition. Sometimes it may be asymptomatic until the blood vessels rupture resulting in haemorrhage which is often the first evident sign of AVM in brain. The patient may experience variety of symptoms. Headache (often confined to one area), weakness or numbness of one side of body and seizures are usually seen among persons without haemorrhage. Individuals with brain haemorrhage may have neurological symptoms like severe headache, weakness/ numbness or even paralysis of body parts, difficulty in speaking, loss of vision and mental confusions.
Symptoms begin to appear around 10-40 years of age but all ages are susceptible. AVM destroys the brain cells and it got worsened over time. The person often experiences difficulties early in adulthood which will become stable with relapsing of symptoms during middle-ages.
Causes of brain arterio-venous malformation
Though the exact reason is unknown, in most of the cases AVM arise early during foetal stage. The network of blood vessels (arteries and veins) in an AVM lacks capillaries. Thus, the blood directly flows between arteries and veins evading the nearby tissues resulting in bulging of the blood vessels.
Male gender is at high risk of developing brain AVM. Pregnancy and family history are another potential risk factors.
Treatment of brain arterio-venous malformation
Management of brain AVM is mainly focused on preventing more serious conditions like haemorrhage. Associated seizures and other neurological ailments are also be treated accordingly. The selection of treatment depends on several factors such as age of the patient, health condition, size of AVM and its location. Oral medications are enough to control headache and seizures but serious cases are to be managed with surgical interventions. Surgical removal of AVM, endovascular embolization and stereotactic radiosurgery are the common surgical procedures adopted to manage brain AVMs.
Complications of brain arterio-venous malformation
Cerebral haemorrhage, reduced oxygen supply to brain cells, weakness of blood vessels, brain damage and hydrocephalus are the common complications of AVM.
Prevention of brain arterio-venous malformation
If the risk of developing an AVM exists, avoid stress, loading heavy weight over the head, smoking, physical exertion and blood thinning medications. These can reduce further complications of AVM.
Ayurvedic Concept of brain arterio-venous malformation
Brain AVM is a doshic imbalance condition in the stage of foetus itself and can be understood as a Sahaja roga. It becomes impossible or difficult to treat in this way. A single term is not coined in Ayurveda for the adult clinical manifestation of brain AVM but it can be understood with a proper understanding of the diseases enumerated in Ayurveda as Apasmara Raktapitta and Siroroga. Ayurveda advises to consider each stage and each patient individually, rather than giving the same treatment to all persons with the same diagnosis. In that way, a case of Brain AVM is analysed according to the dosha kopa and lakshana, and medications and therapies are decided accordingly.
Ayurvedic Nidana of brain arterio-venous malformation
Sukra-artava dosha (dosha imbalance in sperm or ovaum) during conception or anomalies in the stage of foetus
Ayurvedic treatment for brain arterio-venous malformation
Brain AVM is not diagnosed in the childhood ages in most people and they start discomforts after 40’s or later. So, the treatment of the condition deals mostly with adults with a wide variety of clinical complaints. In severe cases, like in acute seizure emergency medical management with first aid facility is recommended. It is better to opt for the opinion of a surgeon if there is an aneurysm.
Ayurveda can help people reduce the discomforts due to brain AVM especially after the surgery. In people with brain AVM, mostly Vaata and Pitta are seen in imbalance. As siras or head is the main seat of Kapha, there is chance for it to increase in quantity or vitiate in a bad way causing obstruction. In such a case, the management should focus on the balancing of most dominant dosha first and ensuring proper channel circulation. If Kapha is more and blockage is there, the approach should be rooksha-swedana (sweating and drying up therapies) in mild form on siras along with appropriate diet. This will help absorb the obstructions and restore the circulation. If Vaata and Pitta are vitiated, brumhana or nourishing therapies are done, with altering Rookshana (drying up) and snehana(oleation). Vaata needs oil application but Pitta should be considered and applied accordingly. Snehapaana is done with caution, followed by mild swedana and virechana. After cleansing of the body thus, Nasya (nasal drops) with suitable herbal formulations is administered. Both internal medicines and external therapies are needed for helping the patient. Apart from medicines, following a healthy diet and regimen is very important. Getting a night time quality sleep and a good quality sleep routine is also very important
Herbal Preparations for brain arterio-venous malformation
Drakshadi kashayam
Brahmi swarasam/choornam/capsules
Pathyashadangam kashayam
Kallyanakam ghrutam
Varunadi ksheeraghrutam
Ksheerabalatailam avarty
Side effect management of brain arterio-venous malformation by Ayurveda
The only way out in an acute case of brain AVM with aneurysm is surgery. Complicated open skull surgical procedures may be needed to save life. But there can be discomforts especially in cognition, coordination and understanding. Ayurveda medicines and Yoga can help the patient feel better and bring back the patient into normal health soon.
Yoga and Pranayama
Brain AVM is a serious condition that needs emergency medical attention. Practising Yoga asanas and pranayama are not suggested in an acute case of brain AVM.
After surgical cure, certain yoga postures like Savasana can help the patient relax and improve the circulation.
Pranayama in its full strength is not recommended in brain AVM as it may trigger another rupture of blood vessels. But proper Anulom-vilom pranayama with professional guidance can help the person improve concentration and coordination.
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
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Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
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