Cerebral parenchymal arteriovenous malformation

Case contributed by Ahmed Abdrabou
Diagnosis certain

Presentation

Headache, vertigo and seizures

Patient Data

Age: 55 years
Gender: Male
This study is a stack
Axial
T1
This study is a stack
Axial
T2
This study is a stack
Axial
FLAIR
This study is a stack
Axial
T1 C+
This study is a stack
Sagittal
T1 C+
This study is a stack
T1
C+
This study is a stack
Axial
SWI
This study is a stack
MRA
This study is a stack
MRA
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Info

Large nidus of malformed vessels with serpigenous appearance (bag of worm) seen involving the right superior temporal and inferior frontal regions. Although large no mass effect could be detected. Arterial supply derived from the right posterior and middle cerebral arteries. venous drainage to the cortical veins and right internal cerebral vein. No hemorrhage could be detected. It displays flow void signal in T2 and SWI with homogenous contrast enhancement after contrast administration.

Case Discussion

Cerebral AVM may be parenchymal, dural or mixed according ot its arterial supply and venous drainage. The hallmark of the disease is the presence of nidus which is a large collection of arteries and veins that communicate with each others without capillary bed though arteriovenous shunting occur.

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