case_images: PMC10960972_01
case_images: Preoperative (a), intraoperative (b), and postoperative (c) images depicting the patient's scalp. Image (a) illustrates a high parieto-occipital mass with associated skin redness. The figure also illustrates the planned horseshoe incision, (b) captures the surgical procedure, and (c) displays the postoperative outcome following complete excision of the AVM.. AVM: arteriovenous malformation.
case_images: 10.1177_2050313X241239531-fig1.jpg
case_images: PMC10960972_01_10.1177_2050313X241239531-fig1.jpg
case_images: fig1-2050313X241239531
case_images: Upon examination, a pulsatile mass was noted (Figure 1), and no abnormalities were found during the neurological examination.
case_images: Preoperative imaging and postoperative outcome of the patient's parieto-occipital AVM. Selected axial (a) and sagittal (b) cuts from brain CT angiography performed on the patient reveal an AVM with the nidus situated at the occipital scalp, measuring approximately 3 cm x 2 cm. The nidus is supplied through enlarged serpiginous superficial temporal and occipital arteries bilaterally with no evidence of skull involvement.. Reconstructed MRA images of the brain with sagittal (c) and axial (d) views better demonstrate the AVM. The nidus appears as a thick mesh of serpiginous vessels located at the posterior scalp and fed by branches from enlarged torturous STAs and occipital arteries bilaterally. The T1W image with IV contrast-sagittal view (e) demonstrates that the nidus drains into the posterior aspect of the superior sagittal sinus, which is also evident by the axial cut selected in picture (f). There is no evidence of intracranial extension of the AVM. DSA with anteroposterior projection of the left external carotid artery injection, demonstrating the involved left STA with no intracranial involvement. The lateral projection of the right external carotid artery injection demonstrates similar findings compared to the left side (g, h). (i): Postoperative head CT scan of the AVM.. CT: computed tomography; AVM: arteriovenous malformation; MRA: magnetic resonance angiography; STA: superficial temporal arteries; DSA: digital subtraction angiography.
case_images: 10.1177_2050313X241239531-fig2.jpg
case_images: PMC10960972_01_10.1177_2050313X241239531-fig2.jpg
case_images: fig2-2050313X241239531
case_images: The computed tomography angiography (CTA) scan demonstrated a lesion of a vascular nature measuring about 3 cm x 2 cm, presumably an AVM beneath the scalp (Figure 2). DSA of the internal and external carotid arteries revealed evidence of shunting with arterial supply from bilateral superficial temporal and occipital arteries (Figure 2).