Presentation
Seizure disorder
Patient Data
A bunch of abnormal vessels in the right frontal lobe subcortical area measuring 1.47 x 1.47 cm.
The feeding arteries are coming from the M4 branch of the right MCA and from ACA.
The draining veins are to the cortical vein and subsequently to the superior sagittal sinus.
Size of nidus: Small (<3 cm) = 1
Eloquence of adjacent brain: non-eloquent = 0
Venous drainage: superficial veins only = 0
There is a hemosiderin-lined cavity in its vicinity in the right frontal lobe (4.3 x 1.6 x 3.7 cm) secondary to a previous lobar hematoma.
Rest of the brain parenchyma is normal.
Case Discussion
The overall features are suggestive of small arteriovenous malformation at the right frontal lobe subcortical area (grade I as per Spetzler-Martin arteriovenous malformation grading system) with sequela of adjacent lobar hemorrhage.
EEG reported: intermittent polymorphic delta, theta with sharp and spike bursts and runs on the right hemisphere accentuated by hyperventilation.
Acknowledgement: Thanks to Dr. Habib ul Rahman Habib; neurologist at FMIC for providing the EEG findings.