PMC5089143_01
CT showing presence of hyperdense lesion in the right parietal region with stippled calcification on the periphery.
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An urgent head computerized tomogram (CT) revealed evidence of a hyperdense lesion with peripheral stippled calcification on the right side in the territory of posterior limb of internal capsule and the retro-thalamic region ( Figure 1).
CT showing presence of coating along the MCA territory.
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There was also coating of vessel along the middle cerebral artery (MCA) territory ( Figure 2) and hyperdensity along the deep venous territory.
Angiogram showing the nidus of the AVM during angiography.
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A four-vessel diagnostic carotid angiography revealed Grade 5 Spetzler-Martin AVM in the right sub corticol region with feeders from lenticulostiates of the middle cerebral artery ( Figure 3).
Angiogram showing the major deep draining vein and a single vein to the superior sagittal sinus.
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Drainage was to the deep draining veins and also to the superior sagittal sinus ( Figure 4).
Excised AVM nidus.
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The lesion was finally excised ( Figure 5).
Post-operative scan with no haemorrhage or the evidence of vasospasm.
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Repeat head CT scan the following morning revealed no cavity hematoma or any evidence of vasospasm ( Figure 6).
Post operative angiography revealing complete excision of the AVM with no residual feeders left.
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Post operative angiography revealed complete excision of the AVM with no remaining feeders ( Figure 7).