Presentation
Unknown.
Patient Data
Non-contrast Brain CT showing a focal area of hyperattenuating cortex associated with sulci effacement and small scattered calcifications along the right frontoparietal transition. Further investigation with MRI was advised.
MRI images depict better which shows to be a cerebral arteriovenous malformation with a compact nidus measuring ~3,1 cm mostly in the superior portions of the postcentral gyrus. The feeding arteries are from of the distal branches of the right MCA and ACA and the venous drainage is performed both by large cortical veins and a large intraparenchymal vein in a downward traject until the junction between the vein of Galen and the straight sinus.
Multiple scattered foci of high T2/FLAIR signal along the deep white matter most likely represent chronic small vessel disease. The remainder exam is unremarkable.
Case Discussion
This case illustrates a cerebral arteriovenous malformation located in an eloquent area (in the somatosensory cortex adjacent to the motor cortex), with a moderate size and with both superficial and deep vein drainage. Accordingly with the Spetzler-Martin grading system, this is a grade 4 AVM.
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