What are the risks of cerebrovascular malformations?

  Vascular malformations can occur anywhere in the skull and are collectively referred to as intracranial vascular malformations. Since they are more common on the surface of the brain and deeper parts of the brain, it is not wrong to commonly call them cerebrovascular malformations.  Cerebrovascular malformations can occur in arteries, veins and capillaries, and are classified as arteriovenous, venous and capillary types. Among them, arteriovenous vascular malformations are the most common, accounting for about 78% of all patients. The arteriovenous vascular malformations are mostly distributed on the surface of the cerebral hemispheres. The malformed vessels in the lesion area are of different sizes, often twisted into clusters, some are extremely dilated, and some have extremely thin walls, in which the arteries and veins are indistinguishable due to free blood traffic. This short-circuiting of arterial and venous traffic deprives the surrounding brain tissue of effective blood supply and, together with the compression of the malformed vascular mass, causes local brain tissue damage. However, the greatest threat is the rupture of the malformed vessels, resulting in subarachnoid hemorrhage or cerebral hemorrhage.  Cerebrovascular malformations are congenital abnormalities of vascular development that develop before the age of 40 in about 70% of patients and manifest most often as hemorrhage, with subarachnoid hemorrhage accounting for about half of the cases. The hemorrhage can recur as long as the cause is not removed. Epilepsy is second only to hemorrhage, with epilepsy as the first symptom in 40% of patients. In addition, headache on one side, progressive hemiparesis, and increased intracranial pressure are common presentations. There are also individual cases of cerebral hemispheric vascular malformations that occur at an early age, resulting in chronic damage and developmental disorders in that side of the hemisphere and causing dysplasia in the contralateral limb, i.e., the contralateral limb develops more slowly and appears relatively thinner and shorter.  Cerebrovascular malformations differ from aneurysms in that they occur primarily on the basis of congenital factors, resulting in an earlier average age than aneurysms. Secondly, the process of damage to local brain tissue from vascular malformations, although slower, is more severe than that of aneurysms. In addition, although the bleeding caused by vascular malformations is not as violent as ruptured aneurysms, it can occur repeatedly; except for subarachnoid hemorrhage, intracerebral hemorrhage is relatively more common than congenital aneurysms.