Left cerebral hemisphere AV fistula

Case contributed by Dr Sangeet Bhalla

Presentation

Persistent left-sided headache.

Patient Data

Age: 55 years
Gender: Male

T1WI images show multiple flow voids are noted along the cortical surfaces.

T2WI images show multiple dilated vascular channels in the left cerebral hemisphere which appears to be arising from left MCA and continuous with the deep cerebral veins and venous sinuses on the ipsilateral side via cortical veins. 

FLAIR images show mild volume loss with some FLAIR hyperintensities are noted in the left occipito-parietal region.

Case Discussion

Serpentine flow voids which show connections between an arterial branch to a venous channel or channels are highly suggestive of AV malformation. These patients are prone to complications like hemorrhage (SDH, SAH and intracerebral hemorrhage) or intracranial hypertension.

Additional MR angiography and DSA angiography were advised for further evaluation.

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Case information

rID: 69800
Published: 25th Jul 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Medeor hospital

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