Beware of cerebral vascular malformations!

Suddenly got a headache, sometimes even stiff, drowsy. Sudden seizures, generalized seizures . It may be a sign of cerebrovascular malformation - a potentially fatal disease.

Three common symptoms

A patient is receiving intravascular intervention to treat cerebrovascular malformation at the University of Medicine and Pharmacy Ho Chi Minh City (Photo: L.TH.H)

On September 30, Ho Thi Sang (BN) Sang (15 years old, Nha Trang, Khanh Hoa) was taken to Ho Chi Minh City Hospital of Medicine and Pharmacy (emergency) in a state of severe blood loss due to bleeding. Massive spontaneous mouth. The skin is pale, hands and feet are trembling, people are drowsy and blood pressure is low.

Ms. Ho Thi Quy - Sang's mother - said three years ago, Sang naturally had bleeding from the upper teeth. After treatment in Khanh Hoa Hospital, patients no longer bleed. Two months later Sang had a second bleeding. The family brought him to Khanh Hoa Hospital, then transferred to the hospitals in Ho Chi Minh City. Finally, Sang was transferred to BVD and the doctor (BS) diagnosed that he had a cerebral vascular malformation (MMN) and a very rare face jaw.

Mrs. Quy said that although she advised him to go to hospital for early treatment, to avoid the risk of deformity causing bleeding, possibly death, but each time she was re-examined, she took her child back due to difficult circumstances. She has four children, both are illiterate. Every day her husband goes to sea to work as a laborer, only VND 300,000 per month. This time too.

On September 29, after Sang was consulted by a foreign expert at BVD, she regretted taking her child to her hometown. The next day, on the way back, Sang suddenly bleed massively from his teeth and had to get back to Ho Chi Minh City.'Now the cost of treating my child is 20 million dong, I borrow it everywhere but it is not enough .' - she said.

Patients with PDD (48 years old, Ben Tre) were also diagnosed with a malformed MMN by BVDHYD, while there was no special expression before. A year ago, the patient suddenly had a headache, stiff neck, drowsiness was taken to the emergency room at Hospital C and was diagnosed with cerebral hemorrhage due to rupture of heterologous form MMN .

Three treatments

Surgery : for patients with a small heterozygous MMN, which is shallow in the brain region does not matter.

Intravascular intervention for congenital malformations: treatable for deformities located in the deep, inconclusive brain region.Depending on the level and number of malformed blood vessels that can interfere with intravascular intervention, or partial blockage, it helps reduce the risk of deformed blockage causing brain hemorrhage, making surgery and radiotherapy effective. higher.

Gamma radiation therapy (Gamma knife): applicable to patients with MMN malformations of small size about 3cm.Most cases of large MMN malformations need to be combined with a previous obstructive vascular intervention followed by radiation therapy.Medical treatment only deals with symptoms caused by MMN deformities, such as reducing headaches, anti-epilepsy.

Also suffering from this disease, in May 2006, patients with TTN (30 years old, Tra Vinh) suddenly had seizures on the whole. The patient was found to have a very large malformation of MMN (6cm) in the temporal area and transferred to DHYD for treatment.

Many hospitals are treatable

Doctor Tran Chi Cuong - Department of DSA, BVDHYD Ho Chi Minh City - said the cause of malformation of MMN is due to the development of blood vessels during fetal period. A US statistic shows that one in every 700 people has this disease.

When deformed mass is not broken, most patients exhibit local or global seizures, absence of consciousness, headache, focal neurological signs such as numbness, weakness of limbs . When natural deformities ruptured (non-traumatic) is often due to excessive deformity of the blood vessels, the patient will have cerebral hemorrhage.

Depending on the degree of bleeding or more, the patient has different manifestations: if the bleeding is severe, the patient may have a deep coma leading to death; mild cases, severe headaches, sudden signs of nervousness such as limb weakness, speech disorders, sensory disorders . If the malformation is located in the visual area, the patient has Blurred vision, if located in the cerebellum area, the patient lost balance, dizziness. When malformed MMN, patients need to be treated early to avoid the risk of deformity.

According to Dr. Cuong, most patients do not know they have the disease. Only when the patient suddenly had severe headaches, seizures, cerebral hemorrhage due to deformed mass, to the newly treated BV was deformed MMN. From October 2004, BVDHYD started implementing vascular intervention through DSA system. After two years of implementation, the hospital has intervened to treat 110 patients with carotid artery carotid artery, malformed MMN, cerebral aneurysm, types of head and neck hemangiomas .

Currently, congenital malformation MMN has not been paid much attention. Previously, the means of diagnosis and treatment of this disease were very limited, but today has improved a lot. In Vietnam, many hospitals have received treatment for malformed MMN by various methods. However, doctors in the province still do not know much about this disease, or do not know but due to lack of information, they do not know what to recommend to any hospital for treatment.

NGUYEN QUANG