Arteriovenous malformation - cerebral
Presents for a follow-up MRI. She had been treated with radiotherapy for a cerebral arteriovenous malformation.
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Single image from an MRA demonstrates a large nidus with prominent flow voids in the left basal ganglia. The nidus extends into the left lateral ventricle. There is high signal within and around the nidus which probably represents gliosis. There are enlarged deep cerebral veins. This AVM is Spetzler-Martin grade 5 (3 for large nidus, 1 for deep venous drainage, and 1 for nidus situated in the eloquent brain).
Management options for arteriovenous malformations include surgical resection, endovascular occlusion, stereotactic radiation, or a combination. Preoperative embolization is frequently used to reduce intraoperative blood loss. Radiotherapy is usually reserved for cases with a low risk of hemorrhage during the treatment period (up to 2 years).