My AVM came back and I don’t know what to do…this is my story

Hi everyone,
My name is Sandra and Im new to this support group. Iv never done anything like this before, I’m hoping that with the support of this group, my journey this time around won’t be as difficult.

Here is my story…
In October of 2004 I was diagnosed with a 3.5cm Brain AVM located in my left lobe. Ever since I was a child I suffered from migraine headaches but never paid much attention to them. It was not until I was 28 where my headaches became more intense that my primary care physician decided to order a CT scan and that’s when my AVM was discovered.

I was instantly referred to a Neurosurgeon for follow up test and treatment options. They quickly determined that it was too risky to surgically remove my AVM because of where it was located. They said I would run the risk of losing some or all of my vision. They decided the best form of treatment would be Gamma-Knife Radiosurgery. I was completely terrified. At that that time I found it so hard to find any information about my condition let alone a support group like this. Luckily I was newly engaged and had a wonderful family who love and supported me. But we were all so lost. I spent so much time on the internet trying to find any and everything about AVM’s which only made me more terrified.

Anyway I just left it in Gods and my Dr.’s hands and proceeded with the Radiosurgery in December of 2004. The procedure it’s itself was not bad but that night when I got home I experienced my first seizure ever. I was rushed back to the hospital where I was instantly placed on anti seizure medications.

After my procedure the headaches continued and I was having horrible side effects from the seizure meds. But to make it even more difficult was that I was starting to have difficulties with the neurosurgeon that treated me. Pretty much after one follow up appointment proceeding the Radiosurgery, it was virtually impossible to get any more appointments with him. They were either getting cancelled or pushed back for moths at a time. I was still suffering from strong headaches and complications with my meds and I didn’t know who to go to. I decided to go back to my primary care physician for help. He then referred me to an incredible Neurologist who took over my case and committed to providing all of my follow up care. He was patient, kind, and more importantly he listened.

Within the year after my procedure the headaches began to diminish. I was also slowly taken off the seizure meds since I did not have a history of seizures outside of that one incident the night of the Radiosurgery.

As every year passed things seem to be going well. I had yearly CT’s and MRI’s to track my progress all the way up until 2007 when we heard the most incredible news in the world. “IT’S GONE” My yearly MRI came out clear with no sign of an AVM; they even did an Angiogram to confirm it. I truly felt like one of the luckiest people in the world. I’ll never forget the day, my husband and I ran out the Dr.’s office screaming at the top of our lungs, IT’s Gone! IT’s gone! The nightmare is over; we called all our family and celebrated. Outside of my wedding day it was truly one of the happiest days of my life!

Between 2007-2009 things couldn’t have been better, I had a clean bill of health, I wasn’t on any medications and completely headache free for the first time in my life! In my over excitement I was also very naive. My neurologist continued to schedule yearly follow-ups for me but I would just skip them, in my mind I was cured. Everything I read, everything the Dr.’s told me was once the AVM is gone, it’s gone for good so as far as I knew that part of my life was over, so I thought.

Towards the end of 2009 going into 2010 I started to experience some odd symptoms. Every time my blood pressure would go up weather it was from exercising, caffeine, stress or just basic straining I would start to get an instant strobe light flashing image in my right eye. Sometimes it was followed up by a mild headache but most of the time it was just some mild visual distortion. Again I didn’t pay much mind to it as I felt that this just might be some after effects of my radiation and it would go away in time, also because the pain was very minimal.

But as the months continued it did not go away and at times the symptoms became more intense. I decided to make my first follow up appointment in 2 years with my Neurologist, just to make sure everything was ok. He ordered another MRI and I was given the results this week Dec. 6 2010. The Dr. walks into the office, nothing could have prepared me for what he told me. Its back he says, it was like a knife through my heart. He proceeded to show me the MRI on monitor and sure enough clear as day a 11.55mm x 17.51mm sized AVM was sitting there staring back at me. I felt like I was in a horrible dream I couldn’t wake up from. After all these years….I just can’t believe it!
At this point, I just don’t know what to do, I feel so defeated. My Dr. is planning to run some more test and scans. He says there may be a small chance that that the mass on my MRI could be scar tissue from my previous treatment but he doesn’t think that’s the case.

He instantly started talking to me about doing a second shot of radiation and also considering using an experimental drug called Bevacizumab also known as Avastin. Right now this drug is only FDA approved for treatment of Cancer patients but he says that they are testing it on AVM patients and have seen some success. It’s a very aggressive drug that needs to be taken via IV for a period of months. I can’t find anything online about this drug and the use of it on AVM patients. If anyone knows anything about this or have used it as treatment for AVM’s please let me know!!!
I go back to the Dr.’s on Jan 14th for the results of the additional test and also to decide on treatments. Any information or advice would be so extremely appreciated.

Thank You all for taking the time to read my story…

Hi Sandra, Sorry to hear that news after so long. Have you had another Angio to confirm it really is a AVM and not scar tissue?

Thank you Brett,
I have one scheduled for Jan 3rd along with some other tests. I will know for sure on Jan 14th when I get my results. I’ll keep my profile updated. Hopefully I can get some more answers…

Hi Sandra,



Welcome to the site. I’m sorry about your AVM returning - I know that disappointment as I found out in September that my spinal cord AVM that had been ‘obliterated’ by embolization has returned.



Like Brett, I’m wondering if your neuro doc is going to have you have an angio to make sure it’s actually the AVM and not scar tissue? Seems like that would be done first before advancing to any treatment. Oh, sorry - just saw your latest post about the angio.



I did a Dogpile search for Avastin and there are quite a few links. Here are a few: http://en.wikipedia.org/wiki/Bevacizumab , http://www.avastin.com/avastin/patient/crc/avastin/what/index.html , http://www.avastin.com/avastin/patient/ .



Keep strong. I know how difficult it is to have to face having and treating this again, but I’m happy for both of us that there is at least some treatment option available. For four years after my bleed I’d been told nothing could be done to help me.



Please keep us posted on your progress.

Hi Sandra.There is a group here within this site called Inoperable AVMs. Perhaps someone in this group will be familiar with the drug you mentioned. I am so sorry that you have to go through this experience again. I will be praying for you!

Hi Sandra,

Sorry to hear the news of the AVM returning. I feel your pain. My daughter’s avm is left occipital lobe. She had 1 embo and 1 Gamma Knife and then we got MRI’s every 6 months for 5 years and everything was looking good. The doc scheduled a 2nd Gamma to ‘finish off the avm’ once and for all! Unfortunately, when they did the angiogram right before the Gamma, the doc found another avm twice the size of the original. Apparently the original avm scarred away but another one formed which was never detected on the MRI. She had her third radiosurgery (LINAC) and is now 18mo post surgery. This has been the worst…3 grand mal seizures and brain swelling. Hang in there…this is just another chapter of your story. Keep positive thoughts and good luck at the Jan 14th appt. Please keep us updated and keep your head held high!

Hi Sandra, welcome to the group. You’ve now got me terrified! I also have been experiencing the strobing like effect with my vision. I was told my AVM was gone, but now I’m not sure. Luckily, I have an appt. with my neurologist on Friday and I am going to ask for more testing to make sure the AVM is gone. I hope that the angio. for you shows that it is just scar tissue. Positive thoughts to you!

Sandra I’m sorry to hear that your avm is back after being told “its gone” years ago. I think we all fear getting this news. On the plus side you didnt have a bleed to find it so that is good. But no one wants to hear those words! Keep your head up and know that you got through it the 1st time you can certainly get through it a 2 nd time. Best of luck and keep us posted!!!

Doe anyone have ANY idea or explanation as to the reason some AVMs reform?

Sandra,

Welcome to the group. There are a lot of helpful people who can provide some insight.

My 8-year-old daughter suffered a massive stroke from a ruptured AVM in January 2009. I was also told it was gone forever (sound familiar?). About a year ago, my daughter started having some unusual coordination and headache problems. A very wise neurologist at home referred us to Mayo Clinic in Rochester. Daughter had an angio earlier this year. When neuroradiologist came out and told us the AVM was back, you could have knocked me over with a feather. Nothing could have prepared me for this.

Because this AVM had already ruptured once, the neurosurgeon didn't take any chances. He opted for the craniotomy, which we believe removed the AVM. My daughter handled her second brain surgery quite well.

A neurosurgeon described the regrowth to me last week. He said any residual tissue from the original AVM will "borrow" "steal" or "take" any veins and arteries it can reach to regrow. I still find myself scared at every unusual thing my daughter does or says. But hopefully the emotion of this year will ease as we get further past this second time.

Hang in there, Sandra. You have a doctor ready to treat this. Getting it before it can rupture is a huge advantage, believe me. Try to stay calm and positive, even if they opt for surgery or gamma or other newer treatment.

Best wishes,

Tina

Hi Sandra, my AVM also grew back. My doctors say that it was bc i was a child when they took it out and my brain was still developing. I'm not sure I believe them, but anyway, find a doctor who has a good bedside manner and go over all the treatment options. Best of luck to you and your family!

Cindy, from what I understand it can redevelops if any part of the AVM was missed originally. AVMs are determined little shi*s, so they will try to regrow with a vengence. I believe that's the only possible way they can come back.

Cindy Phillips said:

Doe anyone have ANY idea or explanation as to the reason some AVMs reform?

Hi Sandra,

Thank you for sharing your story. My thoughts and prayers are with you. I'm going to try to do some research on the drug and get back to you as soon as I see something fabulous! Take great care of yourself and stay positive!!

*UPDATE*

I apoligize for the late update on my situation. Thank you so much for all of your post. This site is truly an incredible place to go for support.

Ok so after 2 MRI's and an Angio within the past 2 months. The Dr.'s confirmed that the mass in my brain was Radiation Necrosis and NOT a reocurance of the AVM. Apparently I developed this Necrosis as a side effect from the radiation treatment I recived in 2004. The Angio I had on Monday the Jan 24th confirmed there was no sign of an AVM. I felt a sense of reliefe untill I started to learn more about Radiation Necrosis and then soon realized I had just traded one problem for another.

Spoke to my Neruo and talkd about treatment options. I asked him what would happen if I just left it alone and did nothing. He said that eventually the Necrosis would get worse, it could take a matter of years but it would just continue to grow and kill healthy brain cells and since the Necrosis is located in my Left Opt. Lobe the continued worsening of the tissue could eventually result in the lost of my peripheral vision.

I felt so cheated, I understand there are risk with treatment but I just did not see this coming.

So as I learn about this condition I realize the treatment options are limited. My Dr. has been using a Drug called Avastin for the past six years to treat Radiation Necrosis. With it he has had great sucess. After lots of reasarch I decided to move forward with this treatment. He will be starting me off on very low doses. This drug needs to be taken via IV and continuously once every 2 to 3 weeks for the next few months. I am currently waiting to schedule my first round of treatments next week so I'll let you know how it goes.

If anyone has had experiance with Radiation Necrosis let me know. Also, Im worried that my insurcance won't cover the Avastin treatments, overall they have been simply horrible I have had to fight them tooth and nail just to get basic test done.

I will admmit my spirits are pretty low right now, but I just keep trying.

Thank you everyone!

Wow! Sandra I don't even know what to say. I guess in some ways this is good news?? Maybe?? I guess when you're comparing things growing in your brain it doesn't really matter what it is, huh?

I must say I'd never heard of Radiation Necrosis, but the I never had radiation treatment. Did your doctors tell you that this would be a possible side effect? Is it rare or fairly common? Is it possible to remove this "thing" through surgery? (not that that is necessarily an option, but I'm wondering)

Sounds like this medicine could work, I hope so. I don't have much to offer in the way of answers regarding insurance. I think the whole insurance industry is full of heartless bastards, but that's not really helpful is it? I would say call them first and find out what and how much they would be willing to cover.

Good luck to you and let us know how it all goes.

Sandra said:

*UPDATE*

I apoligize for the late update on my situation. Thank you so much for all of your post. This site is truly an incredible place to go for support.

Ok so after 2 MRI's and an Angio within the past 2 months. The Dr.'s confirmed that the mass in my brain was Radiation Necrosis and NOT a reocurance of the AVM. Apparently I developed this Necrosis as a side effect from the radiation treatment I recived in 2004. The Angio I had on Monday the Jan 24th confirmed there was no sign of an AVM. I felt a sense of reliefe untill I started to learn more about Radiation Necrosis and then soon realized I had just traded one problem for another.

Spoke to my Neruo and talkd about treatment options. I asked him what would happen if I just left it alone and did nothing. He said that eventually the Necrosis would get worse, it could take a matter of years but it would just continue to grow and kill healthy brain cells and since the Necrosis is located in my Left Opt. Lobe the continued worsening of the tissue could eventually result in the lost of my peripheral vision.

I felt so cheated, I understand there are risk with treatment but I just did not see this coming.

So as I learn about this condition I realize the treatment options are limited. My Dr. has been using a Drug called Avastin for the past six years to treat Radiation Necrosis. With it he has had great sucess. After lots of reasarch I decided to move forward with this treatment. He will be starting me off on very low doses. This drug needs to be taken via IV and continuously once every 2 to 3 weeks for the next few months. I am currently waiting to schedule my first round of treatments next week so I'll let you know how it goes.

If anyone has had experiance with Radiation Necrosis let me know. Also, Im worried that my insurcance won't cover the Avastin treatments, overall they have been simply horrible I have had to fight them tooth and nail just to get basic test done.

I will admmit my spirits are pretty low right now, but I just keep trying.

Thank you everyone!

Hi Sandra, It sounds like I had radiation necrosis, although the doctors never used those words. They basically told me that I had developed a tumor from radio surgery. I discovered this when the tumor ws pressed against my skull, resulting in a stroke. My doctors were able to do a craniotomy and remove the tumor, but I'm not sure this is an option in your case.


I would have preferred to take drugs for it rather than have surgery, but I wasn't given that option since I went to the hospital via ER. I know you don't feel fortunate right now, but I think you are rather fortunate to have caught it before it took over and you can treat it. Good luck to you and keep us posted!

Trish said:

Wow! Sandra I don't even know what to say. I guess in some ways this is good news?? Maybe?? I guess when you're comparing things growing in your brain it doesn't really matter what it is, huh?

I must say I'd never heard of Radiation Necrosis, but the I never had radiation treatment. Did your doctors tell you that this would be a possible side effect? Is it rare or fairly common? Is it possible to remove this "thing" through surgery? (not that that is necessarily an option, but I'm wondering)

Sounds like this medicine could work, I hope so. I don't have much to offer in the way of answers regarding insurance. I think the whole insurance industry is full of heartless bastards, but that's not really helpful is it? I would say call them first and find out what and how much they would be willing to cover.

Good luck to you and let us know how it all goes.

Sandra said:

*UPDATE*

I apoligize for the late update on my situation. Thank you so much for all of your post. This site is truly an incredible place to go for support.

Ok so after 2 MRI's and an Angio within the past 2 months. The Dr.'s confirmed that the mass in my brain was Radiation Necrosis and NOT a reocurance of the AVM. Apparently I developed this Necrosis as a side effect from the radiation treatment I recived in 2004. The Angio I had on Monday the Jan 24th confirmed there was no sign of an AVM. I felt a sense of reliefe untill I started to learn more about Radiation Necrosis and then soon realized I had just traded one problem for another.

Spoke to my Neruo and talkd about treatment options. I asked him what would happen if I just left it alone and did nothing. He said that eventually the Necrosis would get worse, it could take a matter of years but it would just continue to grow and kill healthy brain cells and since the Necrosis is located in my Left Opt. Lobe the continued worsening of the tissue could eventually result in the lost of my peripheral vision.

I felt so cheated, I understand there are risk with treatment but I just did not see this coming.

So as I learn about this condition I realize the treatment options are limited. My Dr. has been using a Drug called Avastin for the past six years to treat Radiation Necrosis. With it he has had great sucess. After lots of reasarch I decided to move forward with this treatment. He will be starting me off on very low doses. This drug needs to be taken via IV and continuously once every 2 to 3 weeks for the next few months. I am currently waiting to schedule my first round of treatments next week so I'll let you know how it goes.

If anyone has had experiance with Radiation Necrosis let me know. Also, Im worried that my insurcance won't cover the Avastin treatments, overall they have been simply horrible I have had to fight them tooth and nail just to get basic test done.

I will admmit my spirits are pretty low right now, but I just keep trying.

Thank you everyone!

HI CINDY THIS IS JUST MY OPINION NO MEDICAL PROOF, YOU REMEMBER THE FIRST PICTURES THEY SHOWED YOU THEY ALL JUST LOOK LIKE A LOT OF VEINS PUT TOGETHER ON THAT SIDE, I THINK WE MAY HAVE MORE THAN ONE IN THE BEGIN BUT UNLESS IT BLEEDS AND LET THEM SEE WHERE THE BLOOD IS COMIN FROM THEY DONT LOOK IN THAT AREA FOR ONE. THEN WHEN THEY DO THE ANGIO AND PUT THE STUFF THEY USE TO SEE HOW LARGE IT IS THEY ARE ONLY LOOKIN ON THAT SIDE. NOW I DO KNOW THIS THEY WILL GROW IF WE DONT DO ANYTHING TO THEM IF THEY ARE SEEN AT AN EARLY AGE AND NOTHIN IS DO TO THEM. MY DOC ALSO TOLD ME SOME ARE NEVER FOUND AND SOME NEVER BLEED. HAVE A GOOD EVENIN
Cindy Phillips said:

Doe anyone have ANY idea or explanation as to the reason some AVMs reform?

HI, OK WE GOIN TO ATTACK THIS NECROSIS HEAD ON WE NOT GOIN TO LET IT GET US DOWNM NOW START AND KEEP PRAYIN YOU KNOW WE SERVE A GOOD GOD AND WITH HIM ANYTHING CAN CHANGE AND HE CAN MAKE ANYTHING HAPPEN WHEN HE GET’S THE GLORY FOR YOUR HEALIN. WE ALL GO INTO THIS WITH MAYBE HAVIN SOME SIDE EFFECTS FROM ANY TREATMENT THAT WE GET BUT LET’S FIRST THANK GOD FOR THIS DAY AND REJOICE IN IT. I LOST MY VISION ON THE LEFT SIDE AND BUMP INTO THINGS HIT MY TOE STEP ON THE DOG LAUGH AND KEEP RIGHT ON GOIN AND SAY THANK YOU LORD I CAN STILL WALK EVEN IF MY BALANCE IS OFF SOMETIMES AND I RUN INTO THINGS IT’S OK 2DAY I AM ALIVE. WE ARE ALL HERE FOR YOU WHEN YOU WANT TO VENT HAVIN A BAD DAY COME ON SITE AND I AM SURE SOMEONE WILL BE HERE. NOW I WILL ADD YOU TO MY PRAY LIST THAT I HAVE AND YOU BE BLESS KEEP GOD FIRST IN ALL THAT YOU DO

Jenny K Ng said:

Hi Sandra, It sounds like I had radiation necrosis, although the doctors never used those words. They basically told me that I had developed a tumor from radio surgery. I discovered this when the tumor ws pressed against my skull, resulting in a stroke. My doctors were able to do a craniotomy and remove the tumor, but I'm not sure this is an option in your case.


I would have preferred to take drugs for it rather than have surgery, but I wasn't given that option since I went to the hospital via ER. I know you don't feel fortunate right now, but I think you are rather fortunate to have caught it before it took over and you can treat it. Good luck to you and keep us posted!

Trish said:

Wow! Sandra I don't even know what to say. I guess in some ways this is good news?? Maybe?? I guess when you're comparing things growing in your brain it doesn't really matter what it is, huh?

I must say I'd never heard of Radiation Necrosis, but the I never had radiation treatment. Did your doctors tell you that this would be a possible side effect? Is it rare or fairly common? Is it possible to remove this "thing" through surgery? (not that that is necessarily an option, but I'm wondering)

Sounds like this medicine could work, I hope so. I don't have much to offer in the way of answers regarding insurance. I think the whole insurance industry is full of heartless bastards, but that's not really helpful is it? I would say call them first and find out what and how much they would be willing to cover.

Good luck to you and let us know how it all goes.

Sandra said:

*UPDATE*

I apoligize for the late update on my situation. Thank you so much for all of your post. This site is truly an incredible place to go for support.

Ok so after 2 MRI's and an Angio within the past 2 months. The Dr.'s confirmed that the mass in my brain was Radiation Necrosis and NOT a reocurance of the AVM. Apparently I developed this Necrosis as a side effect from the radiation treatment I recived in 2004. The Angio I had on Monday the Jan 24th confirmed there was no sign of an AVM. I felt a sense of reliefe untill I started to learn more about Radiation Necrosis and then soon realized I had just traded one problem for another.

Spoke to my Neruo and talkd about treatment options. I asked him what would happen if I just left it alone and did nothing. He said that eventually the Necrosis would get worse, it could take a matter of years but it would just continue to grow and kill healthy brain cells and since the Necrosis is located in my Left Opt. Lobe the continued worsening of the tissue could eventually result in the lost of my peripheral vision.

I felt so cheated, I understand there are risk with treatment but I just did not see this coming.

So as I learn about this condition I realize the treatment options are limited. My Dr. has been using a Drug called Avastin for the past six years to treat Radiation Necrosis. With it he has had great sucess. After lots of reasarch I decided to move forward with this treatment. He will be starting me off on very low doses. This drug needs to be taken via IV and continuously once every 2 to 3 weeks for the next few months. I am currently waiting to schedule my first round of treatments next week so I'll let you know how it goes.

If anyone has had experiance with Radiation Necrosis let me know. Also, Im worried that my insurcance won't cover the Avastin treatments, overall they have been simply horrible I have had to fight them tooth and nail just to get basic test done.

I will admmit my spirits are pretty low right now, but I just keep trying.

Thank you everyone!

Sandra, WOW!! I don’t know what to say. I’m not familiar with radiation necrosis, I don’t even know what it is. Good Luck and I hope this gets better for you.

From what my Dr. Tells me and what I have read online. Radiation Necrosis is a side effect from previous radiation treatment. I recived radiation treatment back in 2004 for my brain AVM. It's a form of radiation damage or scar tissue that had developed at the radiation site where my AVM use to be. Radiation Necrosis can develop any time after radiation even up to 20 years from your inital radiation treatment. I do remember vaugly the Dr.'s telling me back in 2004 that Necrosis was a possible side effect of any form of Ratiation treatment but they said it was rare. But after doing some research online I realize it's is not as rare as it seems. Unfortunatly even though my AVM is gone this Necrosis now has to be treated. Scar tissue on your skin from a cut is nothing like Scar tissue in your brain it can't be left alone becuse within years it will just continue to grow and kill off healthy brain cells ( This is according to what my Dr. told me). I realize now more then ever that even if your told your AVM is gone, yearly followup MRI's are an absolute must especially if you where treated with any form of radiation treatment.

I will be starting my Avastin treatments next Friday, I will let you know how that goes.

God Bless!

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