AVM Update

The history
February, got some low level headeaches and felt somewhat off balance.
April, visit Dr Morrios (my excellent GP) who, after a neurological exams can't find anything- suggests a Brain MRI
May, MRI results come back- Dr Morris suggest that I go to the best guy in Philadelphia - Dr Rossenwasser to look at my AVM (Arterial Venous Malformation).
Mid June(20): Angiogram performed. I was told by Dr Rossenwassers nurse that an embolization (to reduce the flow of blood to the AVM) will be made and the Radiation (Gamma Knife) will be applied.
AVM
AVM is a congenital malformation of the Arteries and Veins, can happen anywhere, but in the brain it is delicate because of the risk of bleeding. Not genetic in nature. My case, after the MRI review and an Angiogram, is located in a low risk area of the brain - no motor or speech areas- more of the thinking area. In normal cases, arteries will take high pressure blood with oxigen to the brain and the capilaries will distrubute the blood through the brain; through the capillaries the blood pressure will decrease and oxigen content will drop. With AVM, there is a 'nidus' of veins that 'shunt' the arterial blood to the vein, at high pressure and fully oxigenated; the risk is that the vein (or the 'nidus') will rupture because of the high blood pressure.

Last update and next steps
July 16: Visited Dr R. Solomon in Columbia Presbeterian- Ken and mami came with me. Dr A\olomon agrees with the assessment that this is a small AVM (smaller than indicated in the Angiogram) and that the radiation option, given my age and the size and location of the AVM, is the best option. No concerns regarding inmediate bleeding risks (no aneurisms). His recommendation is radiation WITHOUT embolization. His argument is that embolization will 'hide' the full extent of the AVM making it difficult to plan the radiation therapy, the risk of the catherization for the embolization and the fact that the glue used will 'protect' part of the AVM from radiation. He stated that, in his experience, embolization + radiation, had lower success rates than pure radiation.
On August 14 I will meet with Dr Rossenwassser. If the difference of opinion is not resolved, a we will need a third opinion. I hope we do not get into this.