case_images: PMC11700262_01
case_images: Postcontrast MRI brain at (A) sagittal and (B-D) axial cuts demonstrating the extent of the AVM (green arrows).
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case_images: PMC11700262_01_gr1.jpg
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case_images: MRI of the brain with contrast (Fig. 1) and cerebral angiography (Fig. 2) showed abnormal vasculature involving the left thalamus, globus pallidus, internal capsule, hypothalamus, suprasellar cistern, body of the left caudate nucleus, lateral putamen, and medial temporal tip as well as increased flow of different compartments of AVM in the left hemisphere compared to the right hemisphere. MRI of the brain 9 months after starting trametinib therapy showed a stable AV malformation.
case_images: (A) Initial MRI brain before trametinib therapy with slightly small left ICA (blue arrow), and (B, C) MRI brain 9 months later after trametinib therapy with (B) progressive narrowing of left ICA (blue arrow) and (C) acute focal ischemia (red arrow).
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case_images: PMC11700262_01_gr3.jpg
case_images: fig0003
case_images: However, compared to the previous MRI, narrowing of the left internal carotid artery (ICA) and acute focal ischemic injury in the left postcentral gyrus were present (Fig. 3).