Arteriovenous Malformations (AVMs) in Children
An arteriovenous malformation, commonly referred to as an AVM, is an abnormal tangle of blood vessels that disrupts the normal flow of blood between arteries and veins. While AVMs can develop anywhere in the body, those located in or around the brain and spinal cord carry the most serious risks — particularly in children,
whose developing nervous systems make early diagnosis and intervention critical.
At Advanced Neurosurgery Associates, our team treats pediatric patients with AVMs across four New Jersey locations, combining advanced surgical expertise with a careful, family-centered approach to care.
What Is a Brain or Spinal AVM?
Under normal conditions, blood flows from the heart through arteries, into smaller capillaries, and then into veins. This capillary network acts as a pressure buffer between the high-pressure arterial system and the lower-pressure venous system. In an AVM, that buffer is missing — arteries connect directly to veins through a chaotic cluster of abnormal vessels called a nidus.
This direct, high-pressure connection puts significant stress on the blood vessel walls. Over time — or suddenly — this can lead to rupture and bleeding into or around the brain, a medical emergency that can cause permanent neurological damage or be life-threatening.
Most AVMs in children are believed to be congenital, meaning they form before birth. However, many are not discovered until symptoms appear or are found incidentally on imaging performed for another reason.
Why AVMs Are Particularly Concerning in Children
AVMs carry a lifetime bleeding risk, and because children have more years ahead of them, their cumulative risk of rupture is substantially higher than in adults diagnosed later in life. Studies suggest the annual risk of bleeding from an untreated AVM is approximately 2–4% per year — and each bleeding event carries a risk of serious neurological consequences.
For this reason, most pediatric neurosurgeons recommend active treatment of AVMs in children whenever it is safely achievable, rather than watchful waiting.
Symptoms of AVMs in Children
AVMs may be silent for years, or they may produce a range of symptoms depending on their size, location, and whether bleeding has occurred. Parents and caregivers should be aware of the following signs:
- Sudden, severe headache — often described as “the worst headache of my life”
- Seizures, which may be the first presenting symptom
- Weakness, numbness, or paralysis on one side of the body
- Vision problems, including double vision or loss of peripheral vision
- Difficulty speaking or understanding language
- Coordination problems or difficulty walking
- In infants, signs of increased intracranial pressure such as bulging fontanelle or rapid head growth
Diagnosis
Diagnosing an AVM involves a combination of advanced neuroimaging studies. The evaluation typically includes:
MRI (Magnetic Resonance Imaging)
Provides detailed views of brain tissue and can identify the location and size of the AVM, as well as any evidence of prior bleeding.
MRA (Magnetic Resonance Angiography)
Visualizes blood vessel structure and helps map the AVM’s relationship
to surrounding brain structures.
Cerebral Angiography (DSA)
Considered the gold standard for AVM diagnosis, this minimally invasive procedure uses contrast dye to produce a precise map of blood flow through the malformation. It is essential for surgical planning and grading the AVM’s complexity.
Our team works closely with pediatric neuroradiology specialists to ensure every child receives a thorough and accurate diagnostic workup before any treatment decisions are made.
Treatment Options
Treatment for pediatric AVMs is highly individualized and depends on the AVM’s size, location, depth, and whether it has bled. The three primary treatment approaches — which may be used alone or in combination — are:
Microsurgical Resection
Open brain surgery to physically remove the AVM is often the preferred approach for accessible lesions, particularly those that have already bled. When complete resection is achieved, the child is considered cured of the AVM. Our neurosurgeons use intraoperative imaging and neurophysiological monitoring to maximize safety and precision.
Stereotactic Radiosurgery
This non-invasive treatment uses focused beams of radiation to gradually obliterate the AVM over a period of two to three years. It is best suited for small, deep AVMs that are difficult to reach surgically.
Endovascular Embolization
A catheter-based procedure in which a physician navigates through blood vessels to inject material that blocks blood flow into the AVM. Embolization is frequently used as a preparatory step before surgery or radiosurgery to reduce bleeding risk and make the procedure safer.
Every treatment plan at Advanced Neurosurgery Associates is developed collaboratively, reviewed by our full clinical team, and discussed thoroughly with the child’s family before moving forward.
Compassionate, Expert Care for NJ Families
Receiving an AVM diagnosis for your child is overwhelming — and you should not have to navigate it alone. Advanced Neurosurgery Associates has four conveniently located offices across New Jersey, in Rutherford, Jersey City, New Brunswick, and Morristown, providing expert pediatric neurosurgical care close to home.
Our surgeons bring deep experience in complex pediatric brain and spine conditions, and we are committed to clear, honest communication with every family we serve — from the first consultation through recovery and beyond.
Arteriovenous Malformations Care Across New Jersey
If your child has been diagnosed with an AVM, or if you have concerns about neurological symptoms, contact us today.