Idiopathic De Novo Arteriovenous Malformation: A Rare Acquired Intracranial Lesion

The de novo development of cerebral arteriovenous malformations (AVMs) in adults is an exceedingly rare event that has prompted the theory that a "second hit" is required to induce AVM formation. The authors document development of an occipital AVM in an adult a decade and a half after a b...

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Bibliographic Details
Published inAsian journal of neurosurgery Vol. 18; no. 2; pp. 400 - 403
Main Authors Plute, Tritan, Agarwal, Prateek, Patel, Aneek, Mallela, Arka N, Lunsford, L Dade, Abou-Al-Shaar, Hussam
Format Journal Article
LanguageEnglish
Published India Thieme Medical and Scientific Publishers Pvt. Ltd 01.06.2023
Subjects
Case Report
genetic
Gamma Knife radiosurgery
seizures
arteriovenous malformations
de novo
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Summary:The de novo development of cerebral arteriovenous malformations (AVMs) in adults is an exceedingly rare event that has prompted the theory that a "second hit" is required to induce AVM formation. The authors document development of an occipital AVM in an adult a decade and a half after a brain magnetic resonance imaging (MRI) disclosed no abnormality. A 31-year-old male with a family history of AVMs and a 14-year history of migraines with visual auras and seizures presented to our service. Because of the onset of a first seizure and migraine headaches at age 17, the patient underwent high-resolution MRI that showed no intracranial lesion. After 14 years of progressively worsening symptoms, he underwent a repeat MRI that demonstrated a new de novo Spetzler-Martin grade 3 left occipital AVM. The patient received anticonvulsants and underwent Gamma Knife radiosurgery for his AVM. This case suggests that patients with seizures or persistent migraine headaches should have periodic repeat neuroimaging to exclude the development of a vascular cause despite an initial negative MRI.
ISSN:1793-5482
2248-9614
DOI:10.1055/s-0043-1769893