[Arteriovenous malformation resembling galenic aneurysm]

Area of Science:

• Neurology
• Pediatric Neurosurgery
• Vascular Malformations

Background:

• A one-year-old infant presented with a generalized convulsive seizure, indicating a serious neurological event.
• Initial examinations revealed a comatose state, right hemiparesis, and rightward conjugate deviation.

Observation:

• CT and MRI scans identified an intracerebral hematoma in the left medial temporal lobe with intraventricular hemorrhage and a dilated venous system.
• Angiography revealed a large venous sac supplied by the left posterior and anterior choroidal arteries, draining into a remnant tentorial sinus.

Findings:

• A two-stage transfemoral embolization successfully occluded feeding arteries.
• Surgical resection via a left subtemporal approach removed the arteriovenous malformation nidus.
• Postoperative recovery was uneventful, with the infant discharged without deficits.

Implications:

• This case highlights the successful combined endovascular and surgical management of a complex pediatric brain arteriovenous malformation.
• The discussion includes embryological origins of such AVMs and the critical role of multidisciplinary treatment approaches.