2016 Volume 38 Issue 4 Pages 267-271
We describe a case of arteriovenous malformation (AVM) presenting with spontaneous alteration of perinidal edema. A 62-year-old man with a history of subcortical hemorrhage was admitted to our hospital because of paresis and numbness of the left lower extremity. Computed tomography (CT) demonstrated a low density area in the right parietal lobe. T2* magnetic resonance imaging (MRI) images revealed a hypo-intense lesion surrounded by edema that was hyper-intense on T2-weighted images and iso-intense on diffusion-weighted images. A cerebral angiogram demonstrated a small AVM with a draining cortical vein emptying into the superior sagittal sinus. A follow-up CT scan demonstrated worsening of the edema around the AVM, accompanied by transient worsening of symptoms. One month later, we performed surgical resection of the AVM. Before the operation, his symptoms had improved. CT scan confirmed regression of the brain edema. MRI demonstrated the alteration of description of cortical vein connected with the drainer. Our case suggests that the perinidal edema was induced by obstructed venous drainage due to stenosis of the draining cortical vein, and improved by restored venous drainage.
