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Updated: Jan 17, 2026
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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
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Arteriovenous malformation within the velum interpositum.
Aleksandar Krbanjevi1, Tibor Valyi-Nagy2
1Department of Pathology, Microbiology and Immunology, Vanderbilt University, United States of America.
Summary
A rare arteriovenous malformation in the velum interpositum caused a thalamic hemorrhage, leading to sudden neurological symptoms. Surgical resection confirmed abnormal vessels, suggesting a possible glial neoplasm.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Neurology
Background:
- Intracerebral hemorrhage can present with diverse neurological deficits.
- The velum interpositum is a rare location for vascular malformations.
- Arteriovenous malformations (AVMs) can cause significant mass effect and hemorrhage.
Purpose of the Study:
- To report a unique case of a thalamic hemorrhage secondary to an AVM in the velum interpositum.
- To discuss the diagnostic challenges and management of this rare presentation.
- To highlight the potential for AVMs to mimic other intracranial pathologies.
Main Methods:
- Case presentation of a 70-year-old woman with sudden onset neurological symptoms.
- Diagnostic imaging including MRI and CT angiography.
- Interventional neuroradiology (embolization) and surgical resection.
- Histopathological and immunohistochemical analysis of resected tissue.
Main Results:
- Imaging revealed a right thalamic intracerebral hemorrhage obstructing the velum interpositum.
- Unsuccessful embolization followed by surgical resection of the thalamic region.
- Histopathology showed abnormal blood vessels and excessive cellularity, suspicious for a glial neoplasm.
- The AVM in the velum interpositum was identified as the cause of hemorrhage.
Conclusions:
- This case highlights a rare AVM in the velum interpositum presenting as thalamic hemorrhage.
- Acute expansion of the cavum by the AVM can cause sudden neurological symptoms like headache and vertigo.
- The findings underscore the importance of considering vascular lesions in the differential diagnosis of thalamic hemorrhages, even with atypical features suggestive of neoplasms.
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