Arteriovenous malformation

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Weakness

Patient Data

Age: 70 years
Gender: Female
mri

Nidus of abnormal serpiginous blood vessels is seen in right parietooccipital lobe. Right posterior cerebral artery seems to reach upto the nidus. Theres is possibly a trifurcation variant anatomy of anterior cerebral arteries with a prominent right cerebral artery. Venous drainage is possibly into adjacent cortical veins and superior sagittal sinus.

Late subacute hematoma measuring approximately 35 x 15 x 36 mm is seen in right parietal lobe, at lateral aspect of above-mentioned nidus of blood vessels.

Few prominent leptomeningeal and dural vessels are also seen in right parietooccipital region.

Chronic lacunar infarcts anterior ischemic demyelination are seen in bilateral fronto-parietal deep and subcortical white matter.

Asymmetric prominence of right lateral ventricle is seen. Bilateral convexity sulci and left lateral ventricle are mildly prominent, likely age-related.

Case Discussion

Findings are suggestive of an arteriovenous malformation with subacute hematoma adjacent to it. Digital subtraction angiography was advised for further evaluation and management.

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