前節骨動脈が流入するIntracerebral arteriovenous malformationの1例

Abstract

A 65-year-old male presented with a seizure attack. He had undergone an episode of stroke 5 years before this admission. CT scans showed a cystic lesion in the left frontal lobe. This lesion was proven to be hemorrhagic stroke by MR imaging. Cerebral angiography disclosed an arteriovenous malformation in the left frontal lobe, fed by the anterior ethomoidal artery. The arteriovenous malformation was accompanied by left internal carotld artery-poste- rlor commumcatlng artery aneurysm. Operative procedures cleared the nidus of AVM, which was confined to the left frontal lobe. Total resection of the AVM and neck clipping of the aneurysm were accomplished. Intracerebral AVM fed by the anterior ettmoidal artery is very rare. Etiology of this rare lesion is unknown. The hypothesis of emergence from embryonal anastomosis between the anterior eth- moidal artery and pial arteries is etiologically plausible. However, older patients predominating in these rare lesions may suggest an acquired hypothesis. This case is an intriguing intracerebral AVM fed by the anterior ethmoidal artery.