Intracerebral arteriovenous malformation: Diagnosis of a case with computerized tomography imaging

Cerebral arteriovenous malformations (AVM) are rarely diagnosed and reported from our region of the world possibly due to the paucity (even unavailability) of the necessary imaging modalities especially digital subtraction angiography (DSA). In this report we present the CT features making for the confident diagnosis of a case of cerebral AVM, even in the absence of a DSA. A 26-year-old man presented recently to us with history of headache not associated with any other general clinical or neurological deficits. An initial cranial contrast CT showed a right parietal 5 x 5cm parenchymal mass lesion with features highly suggestive of an AVM. The follow-up CT angiography later confirmed this lesion to be indeed a high grade AVM involving a high flow fistulous communication between the main branches of the right middle cerebral artery and the deep cerebral venous system. Where there is no facility for DSA like in our own practice there are some specific CT scan imaging features that afford fairly accurate diagnosis of cerebral AVMs.