Coexistence of arteriovenous malformation and cerebral giant aneurysms of 23-year duration without bleeding symptoms
Urszula Łebkowska, Wojciech J Łebkowski, Jerzy Walecki
CaseRepClinPractRev 2001; 2(4):268-270
Background:In 2.7-16.7% cases of intracranial bleeding, the coexistence of arteriovenous malformation (AVM) and cerebral aneurysm or aneurysms is observed. For the first time the pathology has been reported by Lowes in 1925. To the authors' knowledge the up-to-date polish literature doesn't present such pathology with long-term asymptomatic course.Case Report:The case of AVM associated with giant cerebral aneurysms with asymptomatic 23-years course of disease is reported. The pathology was diagnosed in 1978 - the AVM situated within the left frontal lobe and brain aneurysms in the anterior part of left-sided cerebral circulation were visualised with cerebral angiography. In 1996 the CT and cerebral angiography confirmed AVM in the left frontal lobe of the brain, the giant aneurysm of left internal carotid artery in the bifurcation to the anterior and middle cerebral arteries, and additionally the next one aneurysm in the upper part of internal carotid artery. The radical treatment was not decided. All the time since the pathology was diagnosed, the patient is under control and is still active.Conclusions:It is generally accepted in cases of above-mentioned cerebral pathology where clinical symptoms occur (especially bleeding); the only treatment is total elimination of both pathologies from brain circulation. On the other hand there is no accepted standard treatment in cases with asymptomatic course of disease.
Keywords: cerebral arteriovenous malformation, cerebral aneurysm