Cerebral arteriovenous malformation

Case contributed by Dr Mostafa Mahmoud El Feky

Presentation

Headache, seizures.

Patient Data

Age: 35
Gender: Male
Modality: MRI

A bunch of dilated vessels are noted involving right frontotemporoparietal regions showing T2 flow voids as well as T1 hyperintense foci and multiple nidal aneurysmal dilatations. This is associated with multiple aneurysms at the cavernous and pre-communicating segments of right ICA with relative dilatation of the intra-cranial right ICA. It exerts mass effect on the right lateral ventricle. It measured about 7.7 x 5.5 cm at maximum dimensions.

Arterial supply: many feeders including cortical branches from the right middle cerebral and right anterior cerebral arteries which are seen dilated. 

Superficial venous drainage: multiple dilated cortical veins are draining into the superior sagittal sinus.

Deep venous drainage: into right subependymal and septal veins.

Case Discussion

Multiple hyperintense foci at T1 WI reflects hemorrhagic change. This along with other features are consistent with a large arteriovenous malformation. The Spitzer-Martin grading of the AVM is grade V.

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Case Information

rID: 49269
Case created: 17th Nov 2016
Last edited: 22nd Dec 2016
Inclusion in quiz mode: Included

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