Hospital: Hospital Universitario Virgen de la Arrixaca.
Aut@r o Autores: M. Ato González, G. De Paco Tudela, M. Martínez Cutillas, I. Sánchez Serrano, P. Rey Segovia, A. Jiménez Sánchez.
A 34-years-old man with a history of two weeks of headaches was brought to the Emergency system by family members after a first episode of seizures. There was no neurological focal deficits at the explorations. Cranial computer tomography (CT) revealed a slightly hyperdense lesion in left frontal lobe that didn’t cause a significant mass effect. Cranial CT angiogram (CTA) showed a large arterio-venous malformation with a compact nidus, feeding vessels from branches of MCA and ACA, and dilated veins. No hemorrhages were observed. An angiography performed after the acute moment confirmed the diagnosis.·
Cerebral arteriovenous malformations (AVMs), also known as pial arteriovenous malformation, are abnormal vascular connections within the brain. They are composed of one or more feeding arteries, a nidus of vessels, and one or more draining veins, resulting in arteriovenous shunting. Although they are thought to be congenital lesions, their origin remains uncertain and patients tend to present later in life. AVMs are the most common symptomatic vascular malformations with a wide spectrum of clinical presentation that include seizures, headaches, ischemic events or, more often, hemorrhages (65%). In a 15% of patients, they are incidental findings. The radiologist plays an important role in the diagnosis of the AVMs, since the imaging findings may determinate the management of the patient. CT scan, and specially CT angiogram, can provide usefull information, but the angiography remains the gold standard because of its greater definition of the lesion and the pattern of drainage.·
Arteriovenous malformation are abnormal vascular connections within the brain than can manifest in multiple ways, usually with brain hemorrhages. The imaging findings are important not only for the initial diagnosis, but also to guide the patient's management.·
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