Makanjuola A I, Bolaji P, Onyejelam C, Ogbole G I, Akinyemi R O
Neurology Unit, Department of Medicine, University College Hospital, Ibadan, Nigeria.
Department of Radiology, University College Hospital, Ibadan, Nigeria.
Ann Ib Postgrad Med. 2021 Jun;19(1):87-93.
Brain arteriovenous malformations (BAVM) are a cause of intracerebral haemorrhage (ICH) and seizures especially in young patients. ICH due to BAVMs seem to have relatively better neurologic outcomes compared to other causes of spontaneous ICH as patients often recover fully. In this report we highlight a case of delayed diagnosis of BAVM in a young man who presented with seizures and stroke.
A 36-year-old man was referred on account of focal, secondarily generalized tonic clonic convulsions. He had suffered a right ICH 3 years before the index presentation. His general physical and neurologic examination were normal. Electroencephalography revealed right sided focal epileptiform discharges and brain MRI revealed a right parieto-occipital AVM. The seizures were controlled with carbamazepine and he was referred for neurosurgical evaluation.
BAVMs are an important cause of intracerebral haemorrhage and attendant neurologic morbidity especially in young individuals. Neuroimaging plays a central role in BAVM diagnosis and MRI is of great value where facilities and expertise for conventional angiography do not exist. In some instances, delayed presentation of BAVM cases may be due to relatively better neurologic outcomes in BAVM-related ICH.
脑动静脉畸形（BAVM）是脑出血（ICH）和癫痫发作的病因，尤其在年轻患者中。与其他自发性脑出血病因相比，由BAVM引起的脑出血似乎具有相对较好的神经学转归，因为患者通常能完全康复。在本报告中，我们重点介绍一例年轻男性BAVM延迟诊断的病例，该患者表现为癫痫发作和中风。
一名36岁男性因局灶性继发性全身性强直阵挛性惊厥前来就诊。在此次就诊前3年，他曾发生过一次右侧脑出血。他的全身体格检查和神经系统检查均正常。脑电图显示右侧局灶性癫痫样放电，脑部MRI显示右侧顶枕部动静脉畸形。癫痫发作通过卡马西平得到控制，他被转诊进行神经外科评估。
BAVM是脑出血及相关神经疾病的重要病因，尤其在年轻人中。神经影像学在BAVM诊断中起核心作用，在没有传统血管造影设备和专业技术的情况下，MRI具有重要价值。在某些情况下，BAVM病例的延迟就诊可能是由于BAVM相关脑出血相对较好的神经学转归。
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