Acute Hydrocephalus in an Adult Patient Secondary to Unruptured Arteriovenous Malformation

Benjamin S Szewczyk,Bruce I Tranmer,Pouya Entezami

doi:10.31579/2690-1897/077

Abstract

Acute hydrocephalus as a result of unruptured arteriovenous malformation (AVM) is a rare phenomenon in the adult population. Patients with AVMs typically present with hemorrhage, seizures, or focal neurologic deficits. Hydrocephalus may result from obstructing the native cerebrospinal fluid drainage by the malformation’s architecture. We report a previously healthy 32 year-old male who initially presented to an optometrist with blurry vision, visual obscurations, and papilledema. A large right frontal cerebral AVM with hydrocephalus and papilledema was confirmed by MRI. Unfortunately localized lesions may result in hydrocephalus as a rare presentation in unruptured AVMs.

Highlights

Arteriovenous malformations (AVM) frequently present with hemorrhage, headaches, seizures, and focal neurologic deficits
The current study identifies a young male who presented in an unusual fashion for AVMs, with vision changes, headaches, and nausea secondary to hydrocephalus caused by to cerebrospinal fluid (CSF) obstruction by a draining vein
We present an otherwise healthy 32 year-old right-handed male evaluated at an outside hospital for 3-4 months of mild frontal headaches and blurred vision

Summary

Introduction

Arteriovenous malformations (AVM) frequently present with hemorrhage, headaches, seizures, and focal neurologic deficits. AVMs have rarely been reported to cause hydrocephalus or pseudotumor cerebri-like symptoms.1-12 The likelihood of causing obstructive hydrocephalus depends on the location of the nidus and draining veins, as well as flow dynamics. Symptomatology may arise from both the AVM itself (i.e., seizures, hemorrhage, headaches, focal deficits) as well as from hydrocephalus or pseudotumor syndromes (i.e. altered mental status, visual changes, gait disturbances, incontinence).

Results

Conclusion