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Arteriovenous Malformation - Case 8

A 35 year-old woman presented with a severe headache, nausea, vomiting and a change in personality.

Show the AVM Nidus     Show the Arterial Feeders     Show the Large Draining Vein

Arteriovenous Malformation (AVM): Cerebral angiogram: Right internal carotid artery (ICA) injection. (Left) AP view; (Middle and Right) Oblique views. Note the tangle of blood vessels and the large draining vein of the AVM. Also note that the arterial feeders arise from the middle cerebral artery (MCA). ACA = anterior cerebral artery.

Arteriovenous malformations (AVMs) are a congenital abnormality of blood vessels. They consist of a tangle of abnormal vessels supplied by arterial feeders and often drained by large dilated veins. AVMs most often occur in isolation. Rarely, they are associated with genetic disorders, among them: Osler-Weber-Rendu syndrome (hereditary hemorrhagic telangiectasia), Sturge-Weber disease, and von Hippel-Lindau syndrome. AVMs are often asymptomatic. Symptoms, when present, may include:

• headaches (in some cases a unilateral throbbing headache, mimicking a migraine headache)

• seizures (focal, or focal to generalized)

• focal neurological deficits

• bleeding (may mimic subarachnoid hemorrhage from an aneurysm; bleeding from AVMs account for 2% of all strokes)

Larger AVMs are often seen on CT or MRI. Angiography is required to define the vascular anatomy and plan appropriate treatment. Treatment may involve surgical resection, embolization or radiotherapy.


Revised 11/29/06
Copyrighted 2006. David C Preston