Treated cerebral arteriovenous malformation causing radiation-induced vasculopathy
History of right parietal AVM treated with radiosurgery six years ago.
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1. Complete obliteration of the right parietal AVM.
2. Dominant ectatic right Sylvian M2 branch with a 6 mm aneurysmal ectasia at the M2 bifurcation. This branch has multiple beaded stenoses extending distally.
3. Similar albeit milder changes are evident within the ipsilateral parietal MCA and PCA branches.
The appearance of vessels depicted in this case is extremely unusual and is most likely related to an AVM flow phenomenon with subsequent radiation-induced vasculopathy.
No saccular aneurysm in the Sylvian M2 trunk, but rather a fusiform dilatation.