A Rare Presentation of Bilateral Papilledema in a Patient with Cerebral Arteriovenous Malformation

Abstract

A 40 year old lady presented with complete loss of vision in one eye and loss of perception of light in other eye since a year. Initially it was associated with constant headache without vomiting for around 3 months. Indirect ophthalmoscopy revealed chronic pale disc edema and dilated and severe tortuous blood vessels. MRI of the brain showed abnormal dilated tortuous vessels in the left temporal region communicating between basal vein and straight sinus. There was absence of flow voids in both sigmoid sinuses. MRI angiography revealed a small feeding artery to the right transverse sinus from posterior branch of middle meningeal artery. Findings suggestive of chronic raised Intra Cranial Tension were very evident. MRI and MRI angiography revealed a rare occurrence of dural arteriovenous malformation with isolated ocular symptoms and thus cerebral AV malformations with bilateral post papilloedemic optic atrophy was diagnosed. Key-words: Papilloedema, Cerebral AV malformation, Optic atrophy, Dural AV Malformation (DAVM)