Cerebral arteriovenous malformation at posterior body of corpus callosum
Presentation
Headache, vomiting
Patient Data
MRI + MRA Brain
Wedge-shaped clump of variable hyperintense signal is noted in anterior body of right lateral ventricle.
After administration of I/V contrast—
MRI + MRA
A2 segment of left ACA artery courses almost 6-12 mm anterior to right ACA instead of being parallel.
Case Discussion
Differential Dx : Arteriovenous fistula (AVF)
Feeder of AVM : A3 segment of right anterior cerebral artery (ACA)
Drainage : Posterior callosal vein + Subependymal veins of right lateral ventricle
Additional Points
Leakage of I/V contrast into right lateral ventricle indicates intraventricular hemorrhage, most likely arising from the abnormal perforating vessels connecting posterior callosal vein with subependymal veins.
It is likely that there is pressure asymmetry between right & left ACA arteries, due to which none of their segments are parallel to each other. The pressure difference forces the left A2 segment to flip over its right counterpart and lie to the right of the midline! Also, it runs clearly about 1 cm anterior to its counterpart.
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