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DICOM HelpSource: Local (us-east1-c)
Findings
- Arteriovenous malformation centered in the anterior left insula measuring 1.8 x 1.7 cm fed by MCA branches with deep venous drainage via an engorged basal vein of Rosenthal and superficial drainage via several cortical veins
- Surrounding T2/FLAIR hyperintensity in the left insula and left frontal periventricular white matter
- Generalized cerebral volume loss
- Mild patchy T2/FLAIR hyperintensities in the subcortical and periventricular white matter
Diagnosis
Arteriovenous malformation (AVM)
Sample Report
Arteriovenous malformation centered in the anterior left insula measuring 1.8 x 1.7 cm fed by MCA branches with deep venous drainage via an engorged basal vein of Rosenthal and superficial drainage via several cortical veins.
Surrounding T2/FLAIR hyperintensity in the left insula and left frontal periventricular white matter likely represents gliosis related to prior hemorrhage or chronic steal phenomenon.
No evidence of acute infarct, hemorrhage, mass effect, or hydrocephalus.
Background of generalized cerebral volume loss and mild changes of chronic small vessel disease.
Discussion
- When describing AVMs, make sure to comment on whether or not deep venous drainage is present, because this impacts the operative risk
- Steal phenomenon is common with AVMs because they have lower resistance to flow than surrounding capillary beds and hence result in chronic shunting of blood away from the adjacent brain parenchyma