Orbital and Cerebral Arteriovenous Malformations  

Oleh:

Choudhri, Omar ; Chang, Steven Daniel

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 365 no. 13 (Mar. 2011), page 365:e28.
Topik: EYE DISEASES; Fundoscopic Examination; Complex Intraorbital Arteriovenous Malformation
Fulltext: Cerebral Arteriovenous Malformations.pdf (58.85KB)

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Perpustakaan FK Nomor Panggil: N08.K.2011.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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An 8-year-old girl presented with a 3-month history of progressive impairment in the visual acuity of the right eye, along with paresthesias and spastic paresis of the left arm and leg. Fundoscopic examination of the right eye revealed the tortuous blood vessels of a complex intraorbital arteriovenous malformation (Panel A). A scan obtained with the use of magnetic resonance imaging showed extensive flow voids in the right basal ganglia (Panel B, axial image, arrow) and thalamus that were indicative of a cerebral arteriovenous malformation. A digital-subtraction cerebral angiogram revealed two arteriovenous malformations — one within the right basal ganglia, measuring 4 cm in diameter, that was fed by multiple lenticulostriate branches of the middle cerebral artery, and one in the right orbit, measuring 3 cm in diameter, that was supplied by the branches of right ophthalmic artery. This constellation of ipsilateral–intraorbital and cerebral arteriovenous malformations, which is often associated with facial nevi, is recognized as the Wyburn–Mason syndrome. This congenital, nonhereditary disorder stems from a developmental abnormality of the vascular mesoderm in the optic cup and neural tube. The patient underwent stereotactic radiosurgery and arterial embolization of the orbital and cerebral lesions. At 3 years of follow-up, her vision had stabilized and the strength in the left arm and leg had improved. A repeat angiogram showed a reduction in the size of both arteriovenous malformations.

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