Bilateral symmetrical cerebral arteriovenous malformations in the basal ganglia--case report

A 21-year-old male presented with visual disturbance followed by severe headache. Computed tomography showed right thalamic hemorrhage entering the right lateral ventricle. Cerebral angiography revealed bilateral symmetrical arteriovenous malformations (AVMs) fed by the lenticulostriate, anterior choroidal, and lateral posterior choroidal arteries and draining into the vein of Galen. Partial removal of the right AVM induced bleeding on the left side, probably due to postoperative hemodynamic changes. Bilateral symmetrical cerebral AVMs are extremely rare, but provide serious problems for surgical intervention in the deep cerebrum.