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CASE REPORT
Year : 2022  |  Volume : 8  |  Issue : 1  |  Page : 45-49

Dilemmas in managing coexisting arteriovenous and cavernous malformations: Case report


Department of Neurosurgery, University Hospital of Larissa, Biopolis 1, Larissa, Greece

Correspondence Address:
Alexandros G Brotis
Department of Neurosurgery, University Hospital of Thessaly, University Hospital of Larissa, Biopolis, 41110 Larissa, Thessaly
Greece
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bc.bc_52_21

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Coexisting arteriovenous malformations (AVMs) and cavernous malformations (CMs) are rare. Here, we present our dilemmas in managing a patient with a cerebral AVM and a pontine CM. A 47-year-old patient suffered from headaches, vomiting, and transient swallowing difficulties. The cerebral computed tomography showed a pontine hyperintense lesion, while the axial magnetic resonance imaging of the head disclosed a frontal interhemispheric AVM and a CM located in the rostral and ventral aspect of the pons. Despite a pontine hemorrhage, the patient underwent microsurgical excision of the frontal lesion in the first place, due to the increased bleeding risk, followed by stereotactic radiosurgery of the pontine CM. On the 6 months follow-up, the patient's clinical status was stable. A reasonable treatment strategy based on risk stratification is paramount in managing patients with coexisting AVMs and CMs. The optimal outcome frequently requires a staged multidisciplinary approach.


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