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Ruptured Intracranial Arteriovenous Malformation Arising from an Isolated Developmental Venous Anomaly

Wing Mann Ho*, Ronny Beer, Claudius Thome, Claudia Unterhofer

The evolution of de novo Arteriovenous Malformations (AVM) is still unclear. A 46-year-old woman with known drug abuse and a Developmental Venous Anomaly (DVA) in the left basal ganglia diagnosed 18 years previously was admitted with loss of consiousness due to a large intracerebral and intraventricular hemorrhage. Imaging demonstrated an AVM spetzler-martin III at the site of the previous DVA fed by branches of the left middle and posterior cerebral arteries. After CSF drainage and stabilization of the patient, neurosurgical resection of the AVM and hematoma evacuation was performed.

DVAs are considered benign lesions that do not require radiological follow-up. This case indicates that long-standing drug abuse or other risk factors may predispose to DVA transformation into more aggressive lesions.