[Totally thrombosed large arteriovenous malformation--a case report]

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Arteriovenous malformations (AVMs) are typically vascular abnormalities, but rarely present as space-occupying lesions.
• Spontaneous thrombosis within an AVM can lead to mass effect, mimicking other intracranial pathologies.

Observation:

• A 24-year-old woman presented with neurological deficits including homonymous hemianopsia and sensory aphasia.
• Imaging revealed a large, calcified intracranial mass with significant midline shift and ventricular deformity.
• Preoperative diagnosis was suspected to be a teratoma or calcified glioma.

Findings:

• Surgical exploration identified the mass as a totally thrombosed arteriovenous malformation (AVM).
• The thrombosed AVM caused mass effect, leading to displacement of midline structures and deformity of the lateral ventricles.
• This case is unique as it presents a thrombosed AVM causing mass effect without significant hematoma or cerebrospinal fluid circulation disturbance.

Implications:

• Highlights the importance of considering thrombosed AVMs in the differential diagnosis of intracranial space-occupying lesions.
• Suggests that AVMs can enlarge and cause mass effect through mechanisms other than active hemorrhage.
• Contributes to understanding the rare presentations and potential complications of intracranial arteriovenous malformations.