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Question Date: 18/02/2024

Question: A 25-year-old woman presents with a history of left arm automatisms and lip smacking, followed by a generalized convulsion. Her history is also remarkable for recurring headaches previously attributed as migraines. An axial magnetic resonance image (MRI) is shown. Which of the following is considered the most likely diagnosis?

Options:

• Developmental venous anomaly
• Cavernous malformation
• Cerebral aneurysm
• Arteriovenous malformation

Correct Answer: Arteriovenous malformation

View Image: Image_2024013012201265b8e97c1ee9a.jpg

Explaination: AVMs are arteriovenous connections without capillary networks, usually with gliotic brain tissue within the AVM. These often present with hemorrhages, headaches, or seizures. Typically, AVMs are observed if unruptured, but several factors are taken into consideration when determining whether or not to intervene: age, surgical risk, location, gender, and lifetime hemorrhage risk. Treatment options include surgical resection, radiosurgery, endovascular embolization, or a multimodal approach (especially if >3 cm)

Reference: Bradleys NiCP, 7th edn, Chs. 40, pp. 459485 and 56, pp. 758783