EPILEPTIC SEZURES AS THE FIRST MANIFESTATION OF THE FRONTOPARIETAL ARTERIOVENOUS MALFORMATION OF THE BRAIN

Fadilj E Skrijelj, Mersudin Mulic

Abstract


Introduction: Arteriovenous malformations of the brain include a group of congenital disorders in the early development of arterial-venous blood vessels of the brain. Their clinical presentation is most common in the form of a brain hemorrhage, epileptic seizures, and headaches.

Case report: We showed a man who at the age of 28 early in the morning after breakfast had the first generalized tonic-clonic seizure. After the second unprovoked epileptic seizure, antiepileptic therapy was introduced. The brain scanner showed the existence of arteriovenous malformations in the right frontoparietal region. As the size of the malformation was less than 30mm, it was decided that the patient should be treated with Gamma knife radiosurgery. After the successful radiosurgery together with the antiepileptic drugs treatment, the patient is in a stable 1.5 year- long remission of epileptic seizures without neurological failures.

Conclusion: Epileptic seizures can be the initial clinical manifestations of arteriovenous malformations of the brain. With an early diagnosis, adequate antiepileptic drugs therapy and neurosurgery, radiosurgery (Gamma Knife), which is often necessary, many symptomatic epilepsies enter a stable remission of epileptic seizures.


Keywords


arteriovenous malformations, brain, epileptic seizures, radiosurgery, gamma knife

Full Text:

PDF

References


Gault J, Sarin H, Awadallah NA, Shenkar R, Awad IA. Pathobiology of human cerebrovascular malformations: basic mechanisms and clinical relevance. Neurosurgery. 2004; 55(1):1-17.

Fleetwood IG, Steinberg GK. Arteriovenous malformations. Lancet. 2002;359 (9309): 863-73.

Spetzler RF, Martin NA. A proposed grading system for arteriovenous malformations of the brain. J Neurosurg. 1986;65(4):476-83.

Constantino A, Vinters HV. A pathologic correlate of the „steal“ phenomenon in patients with cerebral arteriovenous malformation. Stroke. 1986;17(1):103-6.

Murphy JP. Cerebrovascular disease. Chicago: Year Book; 1954.p.242-62.

Vates EG, Lawton MT, Wilson CB, Dermot MW, Halbach VV, Roberts TPL, et al. Magnetic source imaging demonstrates altrered cortical distribution of function in patients with artheriovenous malformations. Neurosurgery. 2002;51(3):614-27.

Perret G, Nishioka H. Report on the cooperative study of intracranial aneurisms and subarachnoid hemorrhage. Section VI. Arteriovenous malformations. An analysis of 545 cases of cranio-cerebral arteriovenous malformations and fistulae reported to the cooperative study. J Neurosurg. 1966;25(4):467-90.

Foster DMC, Steiner L, Hakanson S. Arteriovenous malformations of the brain. A long-term clinical study. J Neurosurg. 1972;37(5):562-72.

Parkionson D, Bachers G. Arteriovenous malformations. Summary of 100 consecutive supra-tentorial cases. J Neurosurg. 1980;53(3):285-99.

Drake CG. Progress in cerebrovascular disease. Management of cerebral aneurysm. Stroke. 1981;12(3):273-83.

Crawford PM, West CR, Chadwick DW, Slaw MD. Arteriovenous malformation of the brain: Natural history in unoperated patients. J Neurol Neurosurg Psychiatry. 1986;49(1):1-10.

Turjman F, Massoud TF, Sayre JW, Vinuela F, Guglielmi G, Duckwiler G. Epilepsy associated with cerebral arteriovenous malformations. J Neurradiol. 1995;16(2):343-50.

Pilarska E, Lemka M. Epileptic seizures in the vascular malformation in children. Przegl Lek. 2006;66(1):50-5.

Pellettieri L. Surgical versus conservative treatment of intracranial arteriovenous malformations. Acta Neurochir. 1979;29:11-36.

Su HT, Chen KB, Liu YC, Poon KS, Wa RS. Cerebral arteriovenous malformation diagnosed during labor induction with headache and convulsiones as presentations – a case report. Acta Anesthesiol Taiwan. 2005;43(4):247-51.

Kondziolka D, Mc Laughlin MR, Kestle JRW. Simple Risk Predictions for Arteriovenous Malformation Hemorrhage. Neurosurgery. 1995;37(5):851-5.

Al-Shahi R, Pal N, Lewis SC, Bhattacharya JJ, Sller RJ, Warlow CP. Observer agreement in the angiographic assessment of arteriovenous malformations of the brain.

Stroke. 2002;33(6):1501-8.

Heros RC, Korosue K, Diebold PM. Surgical excision of cerebral arteriovenous malformations: Late results. Neurosurgery. 1990;26(4):570-8.

Janičijević M, Rakić M, Đorđić-Vujotić Lj. Hirurgija arteriovenskih malformacija mozga. Chirurgia Urgens. 1995;12(1-2):114-18.

Nagata S, Morioka T, Matsukado K, Natori Y, Sasaki T. Retrospective analysis of the surgical treated temporal lobe arteriovenous malformations with focus on the visual field defects and epilepsy. Surg Neurol. 2006;66(1):625-7.

Husain AM, Mendez M, Friedman AH. Intractable epilepsy following radiosurgery for cerebral arteriovenous malformation. J Neurosurg. 2001;95(5):888-92.

Schauble B, Cascino GD, Pollock BE, Gorman DA, Weigand S, Cohwen-Gadol AA et al.Seizures autcomes after stereotactic radiosurgery for cerebral arteriovenous malformations. Neurology. 2004;63(4):683-7.

Hoh BL, Chapman PH, Loefller JS, Carter BS, Ogilvy CS. Results of multimodality treatment for 141 patients with brain arteriovenous malformations and seizure. Neurosurgery. 2002;51(2):303-11.

Przybylowski CJ, Ding D, Starke RM, Yen CP, Quigg M, Dodson B, et al. Seizure and anticonvulsant outcomes following stereotactic radiosurgery for intracranial arteriovenous malformations. J Neurosurg. 2015;122 (6):1299-305.

Arslan I, Tezcanli E, Yilmaz M, Cizmeli O, Sengoz M, Peker S. Gamma knife radiosurgery for arteriovenous malformations: Clinical Series of 199 Patients. Turk Neurosurg. 2017; 27(2):301-8.

Koltz MT, Polifka AJ, Saltos A, Slawson RG, Kwok Y, Aldrich EF, et al. Long- term outcome of Gamma Knife stereotactic radiosurgery for arteriovenous malformations graded by the Spetzler-Martin classification. J Neurosurg. 2013;118(1):74- 83.

Ding D, Starke RM, Quigg M, Yen CP, Przybylowski CJ, Dodson BK,et al. perebral arteriovenous malformations and epilepsy, Part 1: predictors of seizure Presentation. World Neurosurg. 2015;84(3):645-52.

Ironside N, Chen CJ, Ding D, Ilyas A, Kumar JS, Buell TJ, et al. Seizure Outcomes After Radiosurgery for Cerebral Arteriovenous Malformations: An Updated Systematic Review and Meta-Analysis. World Neurosurg. 2018;120:550-62.




DOI: http://dx.doi.org/10.24125/sanamed.v14i3.330

Refbacks

  • There are currently no refbacks.


Copyright (c) 2019 Fadilj E Skrijelj, Mersudin Mulic

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.