PMC4395961_01
T2-weighted coronal, (a) three-dimensional time of flight (3DTOF) arterial magnetic resonance (MR) image and (b) 3DTOF venous MR imaging (c and d) about 3 x 3 cm size flow void in left fronto-parietal lobe suggestive of venous aneurysm, which is fed by single arterial feeder from left middle cerebral artery and drained by two predominant dilated venous channels to superior sagittal sinus
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F1
The magnetic resonance (MR) imaging angiography of brain showed about 3 x 3 cm size venous aneurysm in left fronto-parietal lobe with multiple varicose venous channels draining to dilated superior sagittal sinus with a single arterial feeder from dilated left middle cerebral artery (MCA) as shown in Figure 1.
Picture showing excised arteriovenous fistula with ligated MC feeder and draining veins
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F2
Then the whole venous varix along with cut end of feeding artery and draining vein was taken out [Figure 2].
Postoperative three-dimensional time of flight arterial (a) and venous (b) magnetic resonance imaging showing nonvisualization of arteriovenous fistula and venous aneurysm
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F3
Postoperative MR angiogram showed absence of AVF and residual postoperative chronic hemorrhage in the left fronto-parietal lobe [Figure 3].