Hello Dr Chahine. My duaghter's 26 year old boyfriend was diagnosed with an AVM back in March 8 2009 when he was hospitalized with an aneurysm inside the AVM. the bleed was successfully embolized then with no complications, he is on Keppra now. Apparently the AVM is in the worst location possible and is inoperable near the hindbrain, pituitary gland and optic nerve. he needs gamma knife surgery (radiation?) but has no more insurance and no doctor will perform this procedure! In the meantime, he has been out of work and awaiting approval of disabilty and medicaid so he can have coverage for the gamma knife procedure. he was told he is not a candidate for repeated embolizations. What an emotional rollercoaster this poor young man has been on!!! All he wants to do is live a normal life without worrying he may die from another bleed or stroke! Is there any advice you can give and please give prognosis if possible? we would like to take my daughter and this young man on a trip this Thanksgiving as long as he gets clearance from his doctors (no flying in a plane). ANY advice is appreciated!! Thank you Noelle in Chicago
Dr. Nassim,
What would you say about this radiologist findings of my MRI scan w/ 10cc magnevist
FINDINGS:
There are numerous foci of hyperintensity in the centrum semiovale rate with a more confluent are adjacent to the occipital horn of the left lateral ventricle. As compared with the previous study from 09/17/2007, the lesions have increased in number in both the right and left hemisphere. Post administration of contrast, there is no abnormal; enhancement. The axial diffusion images are negative for acute infarct. No lesions identified in the cerebellumk or pons. Cerebellopontine angles are normal.
Paranasal sinuses are clear and flow voids in the cavernous portions of the internal carotid and basilar artery are normal.
IMPRESSIONS:
Multiple supratentorial whit matter lesions which have increased in number as compared with 09/17/2007. Differential considerations include primary demyelinating process such as MS, autoimmune mediated vasculitis, Lymes disease. Further evaluation recommended as the lesions have increased in number as compared with previous studies.
In case of severe vomiting, intracranial pressure increases abruptly and some vascular malformations already present since long time could be damaged.. It will be better to do an MRI of the brain to have "'your mind in peace"
Anyways this is not too urgent now, but do it in the next 3 months, and try to do not lift heavy objects or to have constipation.