Presentation
Several days of progressive bilateral frontal and retro-orbital headache post heavy physical exertion. Photophobia. No focal neurology.
Patient Data
Small volume acute intraventricular hemorrhage in the bilateral occipital poles and the body of the left lateral ventricle secondary to a large arteriovenous malformation (AVM) in the left parasagittal parietal lobe and left lateral ventricle. Arterial supply is via the left ACA. Enlarged cortical draining vein from the AVM to the superior sagittal sinus. Additional venous drainage to the straight sinuses.
Rounding of the frontal and posterior horns of the lateral ventricles and flaring of the temporal horns indicating mild hydrocephalus. No mass effect, intraparenchymal hemorrhage or herniation. Normal grey-white matter differentiation is maintained. Basal cisterns are patent.
Left parasagittal Spetzler-Martin grade 2 AVM. A moderately enlarged left ACA is the single feeding vessel. Small posteriorly projected aneurysm arising from the inferomedial border of the nidus.
Case Discussion
This patient presented with a headache that was initially thought to be of a tension/migrainous-type in association with recent cervical strain following strenuous physical exercise. However, the headache was persistent and out-of-proportion, resulting in further investigation. Prompt Onyx embolization of the AVM was achieved following discovery.
Unable to process the form. Check for errors and try again.