AVM Right Occipital Lobe

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rexlyn

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Messages
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Location
NW Arkansas
# of dives
500 - 999
Have been diagnosed with an AVM in the Right Occipital Lobe, this has been confirmed by MRI and angiogram. Dr.'s have stated that diving with Nitrox is not an option and of course diving is not recommended. Why is the higher O2 level in Nitrox a bigger issue than the 21% O2 in Air?

Thank you , Rexlyn
 
One of the potential complications of AVMs is seizures, and Nitrox lowers the seizure threshold. That's the only reason I can think of for advising against Nitrox.

You might PM shakeybrainsurgeon for his input.
 
Dr.'s have stated that diving with Nitrox is not an option and of course diving is not recommended. Why is the higher O2 level in Nitrox a bigger issue than the 21% O2 in Air?

What symptoms were you having that led to the discovery of the AVM in the first place?

Are the doctors advising you familiar with diving?
 
Why is diving contraindicated? Do you have any associated aneurysms? What does DAN say?

Thanks for the info.

Have not contacted DAN as of yet. At this time no aneurysms have been noted. The risk of vasospasms, which is what has caused headaches, severe headaches. But as of yet, diving has not as yet caused this since being diagnosed with AVM.

rexlyn
 
One of the potential complications of AVMs is seizures, and Nitrox lowers the seizure threshold. That's the only reason I can think of for advising against Nitrox.

You might PM shakeybrainsurgeon for his input.

Have not had a history of any seizures, before or after being diagnosed. Appreciate you for your input.

rexlyn
 
What symptoms were you having that led to the discovery of the AVM in the first place?

Are the doctors advising you familiar with diving?

Headaches and headaches with tunnel vision are what started all activity. The loss of peripheral vision led an opthamoligist to determine that something was going on with the optical nerve system or there had been the likelyhood of a stroke. This information was communicated to my Dr. who scheduled an MRI later that day. It determined that there was a mass that was determimed to be an AVM.

rexlyn
 
I don't have much too add beyond what has been said. I can find little in Medscape online literature on the association of cerebral AVM and diving. There is a lot on pulmonary AVM and diving, which can be genetically (rarely) associated with the brain variety --- pulmonary AVM are like PFOs, allowing venous air to enter the cerebral circulation.

In the brain, however, the blood is shunted from arterial to venous, although there still is a direct shunt between the arterial circulation and the venous, so the risk of AGE may be higher theoretically.

Like aneurysms, AVMs have a yearly bleed rate of 1-3%, but AVM hemorrhages are much less dangerous, in general (although they can still do damage). Unllike aneurysms, AVMs tend to be epileptogenic. The risk of diving should be no more and no less than the risk of any other seizure disorder in this regard.

HOWEVER, AVMs are very sensitive to carbon dioxide vasoregulation. The chief theoretical risk of diving is likely the effect of CO2 retention and/or jugular compression from wetsuits/equipment etc, leading to higher risk of AVM rupture. They can be fragile things, as I have experienced first hand. The contraindication of nitrox is mystifying, but seems moot if they don't let you dive.

The good news is that these lesions can often be obliterated with non-invasive radiosurgery or, if necessary, open surgery or embolization (or a combination of the three). The right occipital lobe is not the best place for an AVM (right frontal is better), but certainly isn't the worst. Thus, the situation may not be permanent at all.

The indication for treatment is the production of symptoms (seizure, headache. visual loss, hemorrhage), which seems to be the case here.

Obviously, only your own physicans can advise you of how to treat this and whether you should dive or not.
 
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