Arteriovenous Malformations (and Other Vascular Lesions of the Central Nervous System)

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What Causes Vascular Lesions?

Although the cause of these vascular anomalies of the central nervous system is not yet well understood, scientists believe that they most often result from mistakes that occur during embryonic or fetal development. These mistakes may be linked to genetic mutations in some cases. A few types of vascular malformations are known to be hereditary and thus are known to have a genetic basis. Some evidence also suggests that at least some of these lesions are acquired later in life as a result of injury to the central nervous system.

During fetal development, new blood vessels continuously form and then disappear as the human body changes and grows. These changes in the body's vascular map continue after birth and are controlled by angiogenic factors, chemicals produced by the body that stimulate new blood vessel formation and growth. Researchers have recently identified changes in the chemical structures of various angiogenic factors in some people who have AVMs or other vascular abnormalities of the central nervous system. However, it is not yet clear how these chemical changes actually cause changes in blood vessel structure.

By studying patterns of familial occurrence, researchers have established that one type of cavernous malformation involving multiple lesion formation is caused by a genetic mutation in chromosome 7. This genetic mutation appears in many ethnic groups, but it is especially frequent in a large population of Hispanic Americans living in the Southwest; these individuals share a common ancestor in whom the genetic change occurred. Some other types of vascular defects of the central nervous system are part of larger medical syndromes known to be hereditary. They include hereditary hemorrhagic telangiectasia (also known as Osler-Weber-Rendu disease), Sturge-Weber syndrome, Klippel-Trenaunay syndrome, Parkes-Weber syndrome, and Wyburn-Mason syndrome.

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