Presentation
Persistent left-sided headache.
Patient Data
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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