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Cerebellar arteriovenous malformation

Case contributed by Dr Bruno Di Muzio


Headache investigation revealed hyperintensity in the left posterior fossa on CT study (not available).

Patient Data

Age: 45
Gender: Female

MRI Brain


There is an arteriovenous malformation in the anterior lobe of the left cerebellar hemisphere with a diffuse nidus measuring 2.5 x 2.0 cm. Both the left AICA and SCA are prominent, with the latter probably being the main feeding artery. Veins are draining both to the torcula herophili, left transverse sinus and left cavernous sinus; the most prominent vein goes to the superior petrosal sinus and consequently cavernous sinus. Spetzler-Martin score 2.   

Case Discussion

Cerebellar AVMs are more likely to present with hemorrhage compared to cerebral AVMs. Some authors argue that the Spetzler-Martin score system is not the best option for cerebellar AVM because 1

  • the only eloquent structures in the cerebellum are the deep nuclei  
  • low likelihood of large AVMs involving the cerebellum
  • venous drainage depth generally is artificially elevated by this system: deep venous drainage is all but “cerebellar hemispheric veins that drain directly into the straight or transverse sinus” 1



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