Abstract
The patient, a 32-year-old female, had suffered from convulsive seizures since the age of 18. In August 1968 she had a right hemiconvulsion followed by right hemiparesis. Ligation of the left common carotid artery and external decompression were performed at a local hospital. Neurological examination in October 1970 showed right hemiparesis including the face. Cerebral angiography revealed a left parietal AVM which was fed by the left pericallosal, callosomarginal, central, and precentral arteries. No aneurysm was demonstrated. In March 1980, she was admitted because of an episode of unconsciousness and aggravation of right hemiparesis. CT scan showed a left parietal AVM and right parietal porencephalia communicating with the right lateral ventricle. Right cerebral angiography also revealed the left parietal AVM, unchanged since 1970, and an aneurysm at the bifurcation of right internal carotid artery.
Not only the presence of the AVM, but also some hemodynamic alterations caused by interruption of the contralateral carotid flow with consequent increase in ipsilateral cerebral blood flow might have been responsible for the neoformation of the aneurysm in this case. Such an association of porencephalia with AVM and an aneurysm has not yet been reported.
