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Idiopathic De Novo Arteriovenous Malformation: A Rare Acquired Intracranial LesionFunding None.
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.
Tritan Plute was responsible for data collection, writing and primary generation of the manuscript. Prateek Agarwal was the primary resident involved with the case and provided insight into the case and assisted with writing. Aneek Patel was involved with the case write-up and provided neurosurgical insight. Arka Mallela provided key insight into the research process and assisted with manuscript writing. Lunsford was responsible for identifying the case as novel, obtaining patient consent, writing, and providing expert opinion regarding the case. Abou-Al-Shaar was responsible for the design of the report and advising Plute during the research process; he was also responsible for writing manuscript generation.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee of University of Pittsburgh Medical Center and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from the patient included in the study.
Article published online:
16 June 2023
© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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- 1 Rutledge C, Cooke DL, Hetts SW, Abla AA. Brain arteriovenous malformations. Handb Clin Neurol 2021; 176: 171-178
- 2 Hamada J, Yonekawa Y. Spontaneous disappearance of a cerebral arteriovenous malformation: case report. Neurosurgery 1994; 34 (01) 171-173
- 3 Mahajan A, Manchandia TC, Gould G, Bulsara KR. De novo arteriovenous malformations: case report and review of the literature. Neurosurg Rev 2010; 33 (01) 115-119
- 4 Park H, Koh EJ, Lee EJ, Cheon JE, Kim SK. An acquired cerebral arteriovenous malformation after brain abscess treatment: case report and a review of the literature. Childs Nerv Syst 2021; 37 (09) 2923-2926
- 5 Nagai Y, Anan M, Fujiki M. Cerebral arteriovenous malformations as acquired lesions: case reports and review of the literature. J Stroke Cerebrovasc Dis 2020; 29 (10) 105157 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105157.
- 6 Karlsson B, Johansson AV, Yang HC. et al. A novel method to determine the natural course of unruptured brain arteriovenous malformations without the need for follow-up information. J Neurosurg 2018; 129 (Suppl. 01) 10-16
- 7 Park SO, Wankhede M, Lee YJ. et al. Real-time imaging of de novo arteriovenous malformation in a mouse model of hereditary hemorrhagic telangiectasia. J Clin Invest 2009; 119 (11) 3487-3496
- 8 Tasiou A, Tzerefos C, Alleyne Jr CH. et al. Arteriovenous malformations: congenital or acquired lesions?. World Neurosurg 2020; 134: e799-e807
- 9 Yan L, Tao W, Zhan Q, Huang Z, Chen F, Li S. Angioarchitectural features of brain arteriovenous malformation presented with seizures. Neurosurg Rev 2022; 45 (04) 2909-2918
- 10 Gross BA, Frerichs KU, Du R. Sensitivity of CT angiography, T2-weighted MRI, and magnetic resonance angiography in detecting cerebral arteriovenous malformations and associated aneurysms. J Clin Neurosci 2012; 19 (08) 1093-1095
- 11 Sweeney M, Foldes G. It takes two: endothelial-perivascular cell cross-talk in vascular development and disease. Front Cardiovasc Med 2018; 5: 154 DOI: 10.3389/fcvm.2018.00154.
- 12 Park SO, Lee YJ, Seki T. et al. ALK5- and TGFBR2-independent role of ALK1 in the pathogenesis of hereditary hemorrhagic telangiectasia type 2. Blood 2008; 111 (02) 633-642
- 13 Tual-Chalot S, Garcia-Collado M, Redgrave RE. et al. Loss of endothelial endoglin promotes high-output heart failure through peripheral arteriovenous shunting driven by VEGF signaling. Circ Res 2020; 126 (02) 243-257
- 14 Grossen AA, Shi HH, O'Neal CM, Bauer AM. Impact of obesity and diabetes on postoperative outcomes following surgical treatment of nontraumatic subarachnoid hemorrhage: analysis of the ACS-NSQIP database. World Neurosurg 2022; 163: e290-e300
- 15 Tan MG, Worley B, Kim WB, Ten Hove M, Beecker J. Drug-induced intracranial hypertension: a systematic review and critical assessment of drug-induced causes. Am J Clin Dermatol 2020; 21 (02) 163-172
- 16 Yin R, Lu C, Chen Q, Fan J, Lu J. Microvascular damage is involved in the pathogenesis of heroin induced spongiform leukoencephalopathy. Int J Med Sci 2013; 10 (03) 299-306