Cerebral arteriovenous malformation

Case contributed by Dr Kewal Arunkumar Mistry

Presentation

Longstanding epilepsy.

Patient Data

Age: 40 years
Gender: Male
Modality: MRI

Right  posterior cerebral artery (PCA) is mildly dilated with one of its P3 segment branches supplying a tuft of small tortuous vessels in right occipital lobe which is in turn draining into a the superior sagittal sinus via a large transcortical vein. Findings are consistent with Cerebral arteriovenous malformation (AVM).

There is presence of a large CSF intensity area surrounding the lesion with peripheral hypointense rim on T2 and GRE (hemosiderin rim) likely sequelae to prior intraparenchymal bleed.

Note tortuous course of vertebrobasilar arteries.

Case Discussion

The lesion was graded on Spetzler-Martin AVM grading system.  The nidus of this arteriovenous malformation medium sized and measured 3.2 cm in maximum dimensions (score=2) with involvement of cuneus of the occipital lobe which is an eloquent area of the brain (score=1) and superficial venous drainage into the superior sagittal sinus  (score=0). The lesion was assigned a total of grade III (2+1+0).

 

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Case Information

rID: 35165
Case created: 24th Mar 2015
Last edited: 10th Dec 2015
Inclusion in quiz mode: Included

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