Are Flashing Lights in Vision Linked to Arteriovenous Malformation?

Is the presence of persistent flashes of light related to arteriovenous malformations?

Hello, Doctor! I was hospitalized last December due to bleeding from an arteriovenous malformation.
After receiving medication to lower intracranial pressure, I regained consciousness, but my left eye has remained partially blind since then, and I have been experiencing persistent flashes of light (similar to the shimmering on a lake's surface), even with my eyes closed.
I considered surgery and gamma knife treatment, and ultimately chose to undergo gamma knife surgery on March 2nd of this year.
However, the issues with my eye continue to trouble me.

1.
Is the phenomenon of flashes related to my brain hemorrhage? Is there a chance for improvement or recovery? I have had an eye examination for my retina and lens, but the doctor said everything looks fine and couldn't determine the cause, which is quite frustrating!
2.
Will my partial blindness improve? After the surgery, what should I be cautious about? Is it true that I should avoid alcohol?
3.
I would like to engage in some physical activities, but I have concerns.
Can I go swimming?
4.
Occasionally, I experience sharp pain in the upper right side of my head, approximately where my arteriovenous malformation was located.
What could be the cause of this?

Wenwen, 30~39 year old female. Ask Date: 2010/03/22

Dr. Zheng Zhong reply Neurosurgery

After gamma knife radiosurgery for arteriovenous malformations (AVMs), it typically takes about 2-3 years (depending on the size of the malformation) for the abnormal blood vessels to undergo embolization, eliminating the risk of bleeding.
You discovered the cerebrovascular abnormality due to bleeding; if the bleeding occurs in the visual cortex or along the visual pathways, it may result in visual field deficits.

1.
Flashing lights or visual field deficits are sequelae resulting from damage to the brain's visual areas.
Improvement can occur within a year, but complete recovery is unlikely and depends on the extent of the brain injury at the time of bleeding.

2.
The two main symptoms of arteriovenous malformations are bleeding and seizures.
After receiving gamma knife treatment, it takes 2 to 3 years for the blood vessels to embolize, thus eliminating the risk of further bleeding.
It is important to maintain a regular lifestyle, engage in appropriate exercise, avoid staying up late, and manage emotional fluctuations.
Alcohol consumption is contraindicated as it can trigger seizures.
3.
Swimming is a good form of exercise, but it should be done in moderation.
4.
If the bleeding site irritates the meninges or increases intracranial pressure, headaches may occur.
Following radiation treatment, localized brain edema can also cause headaches.
It is advisable to follow up with your physician; brain edema can be treated with medication.

Reply Date: 2010/03/22

More Info

Flashing lights in vision can be a concerning symptom, especially in the context of a history of arteriovenous malformation (AVM) and associated complications. Given your medical history, including a December hospitalization due to AVM bleeding and subsequent gamma knife surgery, it is essential to understand the potential connections between your symptoms and your past medical events.

1. Flashing Lights and Brain Hemorrhage: The flashing lights you are experiencing, described as similar to the shimmering on a lake, could indeed be related to your previous brain hemorrhage. After a hemorrhage, changes in the visual pathways or the retina can occur, leading to visual disturbances such as flashes of light. These flashes are often caused by the vitreous gel in the eye pulling on the retina, which can happen due to changes in the eye's structure post-surgery or due to the original AVM. While the fact that your eye examinations have shown no significant issues is reassuring, it does not completely rule out the possibility that your symptoms are linked to your past condition. Improvement in these symptoms can vary; some individuals may experience resolution over time, while others may have persistent issues.

2. Visual Field Loss: The left eye's visual field loss (hemianopia) you are experiencing may improve, but this largely depends on the extent of the damage caused by the AVM and the effectiveness of the treatment you received. Rehabilitation strategies, including vision therapy, may help in some cases, but it is crucial to have realistic expectations. Regular follow-ups with your ophthalmologist and neurologist are essential to monitor any changes in your condition.

3. Post-Surgery Care: After undergoing gamma knife surgery, it is crucial to follow your doctor's recommendations closely. Generally, avoiding alcohol is advisable, as it can interfere with recovery and may exacerbate any neurological symptoms. Alcohol can also affect your balance and coordination, which is particularly important given your history of brain issues.

4. Exercise and Swimming: Engaging in physical activity is beneficial for overall health, but caution is warranted. Low-impact exercises, such as walking or gentle stretching, are usually safe. Swimming can be a good form of exercise, but you should consult with your healthcare provider before resuming any activities, especially if they involve submerging your head underwater. This is to ensure that there are no risks associated with pressure changes or potential complications from your previous condition.

5. Pain in the Right Side of the Head: The occasional pain you feel in the right side of your head, near the area of your AVM, could be related to several factors, including post-surgical changes, nerve irritation, or even tension headaches. It is essential to discuss this symptom with your healthcare provider, as they may want to conduct further evaluations to rule out any complications or new developments.

In conclusion, while flashing lights in your vision can be linked to your past AVM and its treatment, it is crucial to maintain open communication with your healthcare providers. Regular monitoring and a proactive approach to managing your symptoms will be key to your recovery and overall well-being. If your symptoms worsen or new symptoms arise, do not hesitate to seek immediate medical attention.

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