Cerebral Arteriovenous Malformation

cerebral_AVM

This 32 year-old female patient presented for a follow-up MRI. She had been treated with radiotherapy for a cerebral arteriovenous malformation. The axial T2-weighted MR image shows a large nidus with prominent flow voids in the left basal ganglia. The nidus extends into the left lateral ventricle. There is high signal within and around the nidus which probably represents gliosis. There are enlarged deep cerebral veins.

This AVM is Spetzler grade 5 (3 for large nidus, 1 for deep venous drainage, and 1 for nidus situated in eloquent brain).

Management options for arteriovenous malformations include surgical resection, endovascular occlusion, stereotactic radiation, or a combination. Preoperative embolisation is frequently used to reduce intraoperative blood loss. Radiotherapy is usually reserved for cases with a low risk of haemorrhage during the treatment period (up to 2 years).

Reference: Osborn AG. Diagnostic Neuroradiology Mosby. 1994.

Credit: Dr Laughlin Dawes