PMC2718202_01
A. Axial enhanced CT reveals a left occipital arteriovenous malformation (open arrows). A hematoma (arrows) is seen in the left parietal lobe. No feeding artery appears in this section.. B. Lateral angiograms of the left internal carotid artery disclose an occipital arteriovenous malformation fed by the left posterior parietal artery and branches of the posterior cerebral artery.. C. Anteroposterior test injection shows contrast extravasation into the subarachnoid space at the point at which the parieto-occipital branch changes direction, the site of the microcatheter tip, approximately 1.5 cm from the nidus.. D. Plain lateral view shows a mixture of histoacryl and lipiodol after occlusion of the arterial rupture with glue (arrow), and change in the position and shape of the initial extravasation of contrast medium is seen. Note the presence of glue cast arising from initial embolization of the left posterior parietal artery (open arrows).. E. Plain lateral view obtained 139 minutes after initial contrast extravasation shows no evidence of further extravasation.
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A 42-year-old man, who had complained of seizure and headache, was admitted to another hospital, where angiography and CT revealed an AVM in the left occipital lobe, with hematoma (Fig. 1A). Preembolic cerebral angiography revealed a left-sided occipital AVM fed by the left posterior parietal artery and branches of the left posterior cerebral artery (Fig. 1B). A lateral injection demonstrated no evidence of extravasation, but an anteroposterior injection revealed the extravasation of contrast medium at the point at which the parieto-occipital branch changed direction, at the a site of the microcatheter tip, approximately 1.5 cm from the nidus (Fig. 1C). The extravascular compartment were sealed with a small amount of a 40% mixture of histoacryl and lipiodol, injected through the same Magic catheter (Fig. 1D), then the patient's headache disappeared completely. Extravasation of the contrast medium was no longer evident (Fig. 1E).