The week-long wait between the eventful angiogram day and the followup was not fun, but it finally arrived.
We went back to the neurosurgery unit at OHSU and met with the surgeon's attending (I think?) who reviewed the angiogram with us. He confirmed what everyone had been saying. It was an AVM. A tangle of blood vessels. In his brain. Okay.
He talked through each of the different treatment approaches, their likelihood of success, the risks, and the recovery that went with each of them.
He told us that based on the size (relatively small) and location (near the surface) of Tim's AVM, he was recommending a combination of both option one and option three. He explained that performing an embolization right before surgery would be beneficial because it would reduce the likelihood of bleeding during surgical removal.
He went on to say that Tim was not necessarily in immediate danger from the AVM, but that leaving it untreated could result in hemorrhage (bleeding in the brain), seizures, or even neurologic deficits. He assured us that because Tim is young, healthy, and in good shape, it was actually an ideal AVM to operate on, as far as AVMs go.
We talked about the risks and the expected recovery time. He estimated that the schedule would look something like this
Embolization: 1 day in the procedural care unit
Surgery: (the day after embolization) 4-6 hours for the surgery (and coming out of anesthesia), 1 day of monitoring in the ICU
Recovery: 1-3 weeks of recovery in the hospital and another 2-3 weeks of recovery at home
February 1st
We went back to the neurosurgery unit at OHSU and met with the surgeon's attending (I think?) who reviewed the angiogram with us. He confirmed what everyone had been saying. It was an AVM. A tangle of blood vessels. In his brain. Okay.
He talked through each of the different treatment approaches, their likelihood of success, the risks, and the recovery that went with each of them.
- Option 1: Embolization. For this option, they basically repeat what they did for the angiogram (insert a catheter into the femoral artery, which is fed up to the brain) but instead of injecting dye, they inject a glue-like substance. This reduces blood flow to the AVM and can sometimes help to decrease the size. Definitely not a complete solution.
- Option 2: SRS. This option uses stereotactic radiosurgery, which basically means they take a focused beam of radiation and destroy blood vessels that are feeding into the AVM. (There are a couple of different types of methods that they use for this, but Tim was most excited about one called a "gamma knife." What a nerd.) Again, not a complete solution and it would potentially take years for the AVM to reduce in size.
- Option 3: Surgical removal. This option is pretty self-explanatory. Incision, removal of part of the skull, and then they resect the AVM. The scariest option, in my opinion, but the only one that would completely remove it.
He told us that based on the size (relatively small) and location (near the surface) of Tim's AVM, he was recommending a combination of both option one and option three. He explained that performing an embolization right before surgery would be beneficial because it would reduce the likelihood of bleeding during surgical removal.
He went on to say that Tim was not necessarily in immediate danger from the AVM, but that leaving it untreated could result in hemorrhage (bleeding in the brain), seizures, or even neurologic deficits. He assured us that because Tim is young, healthy, and in good shape, it was actually an ideal AVM to operate on, as far as AVMs go.
We talked about the risks and the expected recovery time. He estimated that the schedule would look something like this
Embolization: 1 day in the procedural care unit
Surgery: (the day after embolization) 4-6 hours for the surgery (and coming out of anesthesia), 1 day of monitoring in the ICU
Recovery: 1-3 weeks of recovery in the hospital and another 2-3 weeks of recovery at home
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