The Brain After Surgical removal of AVM's

Hi guys, This may be a stupid question ... but does the brain "reform" after AVM removal surgery or are you left with a "gap" where the surgery has removed the AVM/brain tissue. This is just a curiosity question as I have surgery pending, But I guess the same questions would apply after tumour removal etc ?. does the brain just reshape itself back to a normal type shape ?, I know this would all depend on how much is removed etc .. but just a basic type question that I will be asking my surgeon but I'm not really sure why I want to know ... I guess it would make me feel a little easier if I knew the answer. Thanks.

Hi martin,

I think it depends on the size of the avm maybe and where it is in the brain, I know that when I seen my before and after MRI pics there is no hole where my avm was it just looks "normal".

although you can still see on the MRI where they went into the brain to remove it its like a line is the best way I can describe it , not sure how long that will take to look normal again or maybe it will be like that forever.

my AVM was in my right frontal lobe hope this helps a little

Thanks Darren, I guess it must all squeeze together again ... but I'm just guessing ... its really a silly question because it doesnt matter how it looks on the inside ... I'm just curious :). Thnaks for your reply.

I had AVM surgery 27 years ago, and recently had an MRI due to having seizures again. The tech that took the MRI told me the portion of the brain that the AVM was removed from looks like a jumbled mess. I got the impression it does not grow back into a "normal" looking brain in that area. Mine was fairly large. Approximately 300 veins were removed. I have no idea about tumors... maybe someone else will.

Thanks Jill, Its more a curiousity thing for me. I guess it doesnt matter as long as I'm AVM free and healthy afterwards :) . Thanks again for your reply, Hope your seizures get under control soon and you have health and happiness :) . Take care.

My son's last MRI had the appearance of a dark "hole" on his MRI. He is very normal functioning except for some higher level executive function skills - time management mainly. He'll be two years post AVM rupture, angio and AVM removal in June.

Hi Brett's mom, Thanks for your reply. Wishing Brett Health and happiness :) . Take care.

Don't be too discouraged at the idea that a part of the brain does not regenerate. Other areas of the brain may take over to some extent for the part that has been lost. Children who have lost an entire hemisphere of the brain, for instance, can lead relatively normal lives, as the other hemisphere takes on the functions of the missing hemisphere. Neuroplasticity is an amazing thing. :)

Thanks dancermom, The main thing is for me to be positive and healthy, I don't suppose it matters what it looks like on the inside as long as I'm ok :) . Thanks again.

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Hi Martin,

I had my surgery Dec 2011 and asked my surgeon that very question in June 2012. Like you, I was also curious. He told me that the area that has been removed will fill with cerebrospinal fluid only and no, the brain will not "reform" as such. I noted that on a subsequent MRI scan, there appeared to be a black hole where that part of my brain was missing. I think in very young children the brain can regenerate to a certain degree but not so much in adults but I'm no doctor. I do suggest you write down a list of all the questions you have, regardless of how "stupid" you think they may be. They are not stupid at all, it's your brain and you just want to know what is going to happen to it that's all. Good luck with your treatment.

Tracie xx

Hi Martin, I believe the short answer is "it depends" several facets of AVM mumbo jumbo (size, location, etc). My AVM was removed June '93. Not until they started digging around was it discovered that it was much deeper than the surgeons initially determined it to be. Then about 10 years ago I had an MRI for something unrelated. A sort of small void exists where the AVM was. A black hole of sorts in my brain. No ill effects from it so far as I know. For whatever it's worth I was 33 and in peak physical shape when I had my surgery. Went under the knife early Thursday morning. Woke up late Saturday, starving to death! Went home Sunday. Four days! Bare in mind I wasn't able to walk for about a month. Doctors warned me that just the trauma of the surgery would completely throw off my equilibrium. Took about a month to get that back. Technology is so much more advanced these days. So you'll be fine.

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Hello Martin . I hope you’re okay knowing that the tissue does not regenerate . It can sound rather stark when we we say it . But cerebrospinal fluid fills in and we go forward without the unwanted AVM which was taking up space and causing troubles . Brains are amazingly capable of making the best of what we have even if it means finding new paths around old neighborhoods . Be good to you . Take care of you .

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Hi Marianne, Yeah I fine with it, It doesn't matter what it looks like on the inside .. or the outside for that matter as long as I'm healthy :) . If its true that we only use 10% of our brains then I guess that I may just have to use other parts that have been resting as you said :) . For me its no big deal I was just curious :) .

But thanks for your reply, Wishing you health and happiness :) . Take Care.

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Martin I have to say that it was a bit unnerving to see my post surgery MRI and see just black spots where part of my brain used to be. My AVM was completely removed (yippee) but I suppose some of my brain was bound to go along with it. The defecits that I have however are from my bleed and not from the crani. At least that's what my neurosurgeon said and I tend to believe that. He believes that had I known about the AVM before the bleed he could have removed it safely and I would be a whole lot better off than I am now. I hope that helps?

Hi Trish, I'm sitting here working and checked my email. Reading stories like yours over the years make me realize how fortunate I was to discover my AVM before a bleed. After digging around my brain to remove it some of my family and friends tell me it's an improvement!

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Hi Trish, Thanks for your response and I can totally relate to what you mean :( , But being AVM free means no more ticking time bomb :) . This is my goal and have AVM removal surgery scheduled (I'm just waiting on the date) I have a very small numb patch on my right upper thigh that I hardly notice and has no affect on my day to day life which is really the only side affect from my initial bleed and craini afterwards. Fingers crossed I have the same results with my next surgery and will be AVM free :) . Wishing you well and thanks again.

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Hi there, I have a similar question. What is expected for recovery in brain surgery in the cerebellar area? It is either avm, blood spill or cavernoma that formed needs to be removed. Doctors are still not sure.

neurological deficits have increased and we don't know what to expect. looks like surgery is the only gamble for hope.

I was actually wondering the same thing after watching a video of AVM removal surgery (I find brain surgery videos fascinating even before I found out that i had an AVM!) While watching the surgery I noticed that it seemed like the doctors were taking out tissue along with the AVM. It didn't occur to me until that point that doctors may also have to remove some of the brain tissue in order to remove the AVM as well. I also remember reading a description of a person's brain after AVM removal surgery in the book "Another Day in the Frontal Lobe" as leaving a large empty spot in the area where they removed the AVM.

That being said...the brain does some amazing things! As someone mentioned there are kids who have an entire hemisphere of their brains removed in order to combat a specific type of seizure that have not responded to medications. And there are adults that have areas of their brains removed in order to treat seizures that have not responded to medication as well and go on to lead full and wonderful lives. The brain has plasticity to it and when a specific area of the brain is rendered "dead" often times whatever that area of the brain controlled will move to another area of the brain. It takes a little bit of work on our parts especially if we are older and our brains have already developed, but it is totally possible and as it can be seen with many people here, totally attainable!

Interestingly enough, because AVMs consist of a tangle of blood vessels that lack capillaries, often times the area of our brain where the AVM is located is "dead" tissue since it has not received oxygen for most of our lives. I had a functional MRI done after my diagnosis and my doctor actually found that the motor function for the left side of my body which should have been located where my AVM is, was actually located in a different area of my brain. :)

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Ah :) , Thanks for this info. I guess I'll read as much as I can and then know as much as I want to know :) . Again thanks and take care all.