case_images: PMC11825632_01
case_images: Axial non-contrast head CT demonstrating intraparenchymal hemorrhage in the posterosuperior aspect of the right frontal lobe
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case_images: PMC11825632_01_701_2025_6455_Fig1_HTML.jpg
case_images: Fig1
case_images: CT scan at the time of presentation showed a large right posterior frontal intraparenchymal hemorrhage (Fig. 1).
case_images: Preoperative catheter angiography. A- Oblique view of the selective left internal carotid artery injection demonstrating the parasagittal micro-nidus of the micro-AVM (white circle). B- Lateral view of the arterial phase of the selective right internal carotid artery injection demonstrating the area of the micro-AVM's micro-nidus (white circle), the cortical draining vein into which the micro-AVM drains immediately anterior to the nidus (black arrow heads), and the location into which the cortical draining vein enters the superior sagittal sinus (white arrowhead). C- Lateral view of the venous phase of the selective right internal carotid artery injection demonstrating a large frontal vein coursing posteriorly to enter the superior sagittal sinus. As the vein enters the superior sagittal sinus immediately anterior to the micro-nidus of the micro-AVM, it is used as an intraoperative landmark to aid in identifying the micro-nidus
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case_images: PMC11825632_01_701_2025_6455_Fig2_HTML.jpg
case_images: Fig2
case_images: At 6-month follow-up, catheter angiography demonstrated a right posterior frontal micro-AVM (Fig. 2).
case_images: Preoperative stereotactic CT angiography. A- Sagittal view demonstrating the ill-defined micro-nidus of the micro-AVM (black arrowhead) at the anterosuperior border of the intraparenchymal hemorrhage cavity (white dashed outline). B- The small cortical vein into which the micro-AVM drains (white arrow heads) approaching the superior sagittal sinus immediately posterior to the large frontal vein (black arrow heads) identified on the preoperative catheter angiogram. C- The shadow of the small draining vein (white arrow) seen approaching the superior sagittal sinus between the large anterior frontal vein (black asterisk) and another posterior frontal vein (black arrowhead)
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case_images: PMC11825632_01_701_2025_6455_Fig3_HTML.jpg
case_images: Fig3
case_images: He underwent microsurgical resection of the micro-AVM with the aid of pre-operative CT angiography (Vid.1 & Fig. 3).
case_images: Lateral views selective right internal carotid artery injections arterial (A) and capillary (B) phases showing obliteration of the micro-AVM. The white circles depict the area of the micro-AVM prior to microsurgical obliteration
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case_images: PMC11825632_01_701_2025_6455_Fig4_HTML.jpg
case_images: Fig4
case_images: Postoperative catheter angiography demonstrated complete obliteration of the micro-AVM (Fig. 4).