BRAIN TUMORSANEURYSMSVASCULAR MALFORMATIONSTRIGEMINAL NEURALGIASPINE NECK BACKPARKINSONS DISEASEHEMIFACIAL SPASMCARPAL TUNNEL SYNDROME


Case Presentation:

AVM R Temporal - Case 2


History & Physical

  • 50-year-old right handed man who presented with sudden onset of headache and sudden loss of visual field.

  • His neurological examination showed right homonymous hemianopsia (loss of vision in right visual field), and upper tract signs in right upper and lower extremities.

 



Imaging


Case 2 Image 1
CT scan of his brain shows a left occipitotemporal hemorrhage.

Case 2 Image 2

MRI scan of his brain shows the source of this hemorrhage to be a probable arteriovenous malformation (AVM).


Case 2 Image 3

Case 2 Image 4

Cerebral angiography confirmed the diagnosis of a complex arteriovenous malformation (AVM) which was supplied by anterior circulation (left slide) and posterior circulation (right slide).



Computer Navigation


Case 2 Image 5
Computer navigation and stereotaxy was utilized to precisely model and map the AVM for surgical planning. Feeding branches were individually marked and systematically approached during the operation.

 

 


 

 

Surgical Procedure

 

  • He underwent angioembolization of the AVM followed by right occipitotemporal craniotomy using stereotaxy and computer navigation, together with intraoperative neurophysiological monitoring with complete resection of this AVM.

 


 

 

Pathology


Case 2 Image 7
The AVM was removed without any difficulty during surgery and sent for pathological evaluation which confirmed the diagnosis.





Post-op Imaging


Case 2 Image 8
Before Operation

Case 2 Image 11
After Operation

 

Post-op cerebral angiography of anterior circulation shows no residual AVM and intact normal cerebral vasculature.



Post-op Course

 

  • He did well post-operatively with no neurological deficit. His visual field deficit progressively improved. He was discharged home and returned to his home state in good health.