Arteriovenous malformation (AVM) is an abnormal connection between the arteries and veins in the brain, making it the most common cause of intracranial hemorrhage in children. Treatment options include surgery, radiosurgery, and irradiation depending on the patient’s condition. Dilated pupils and nystagmus are not symptoms of AVM. Seizures are seen if the AVM has hemorrhaged.
AVM places patients at risk for hemorrhage and rebleeding after surgery. Signs and symptoms of hemorrhage include severe headache, seizures, decreased level of consciousness, hypotonia, irritability, decreased hemoglobin, and abnormal eye movements in a patient that is slowly deteriorating. Signs and symptoms in a rapidly deteriorating patient include coma, apnea, seizures, and unreactive pupils. Creating a calm environment keeps intracranial pressure (ICP) low and decreases vasospasm.
The cause of congenital neurologic abnormalities is unknown. A ventriculoperitoneal shunt may be indicated if hydrocephalus is present to decrease intracranial pressures. Nursing diagnoses include potential for infection after surgery, potential for decreased cardiac output related to anaphylactic shock from latex hypersensitivity, altered cerebral tissue perfusion related to increased ICP due to hydrocephalus, and altered elimination related to decreased innervation of bladder, urinary sphincter, and lower intestines.