A case of unruptured tectal located AVM presenting with obstructive hydrocephalus

Abstract

We present a case of arteriovenous malformation with aneurysmatic dilatation of the drainage vein, presenting with obstructive hydrocephalus located in the tectum. A 59-year-old female patient was taken to the emergency department after complaining for 8 days of increasingly worsening headache, gait disturbance, sleepiness, blurred vision, and double vision, as well as gush vomiting. The patient indicated that he had been experiencing from intermittent headaches for almost a year. On examination, there was an ataxic walk, bilateral papilledema, and slight cognitive impairment. CT, MRI and CTA imaging tests were used for the diagnosis, respectively (Figures 1-3). CT scans of the brain revealed triventricular hydrocephalus and a dense space occupying lesion thought to produce aqueductal stenosis in the tectal region of the mesencephalon (Figure 1). Following that, the patient had brain MRI and CTA imaging. This dense lesion in the tectum was found to be a vascular structure connected to the adjacent arteriovenous capillary network and the vein of galena (Figure 2,3). In the differential diagnosis, arteriovenous malformation with aneurysmatic dilatation in the drainage vein was considered primarily.