Cerebral Arteriovenous Malformation Presenting as Acute Lacunar-Like Infarct Associated with Vascular Steal
김태원, 이승재,
소속 상세정보
김태원 ( Kim Tae-Won )
Catholic University College of Medicine Incheon St. Mary’s Hospital Department of Neurology
이승재 ( Lee Seung-Jae )
Soonchunhyang University Bucheon Hospital Department of Neurology
Abstract
Cerebral infarction associated with cerebral arteriovenous malformation (AVM) is extremely rare. Herein, we describe a unique case of cerebral AVM presenting as acute lacunar-like infarction associated with vascular steal. A 46-year-old hypertensive man presented with a 2-day history of dysarthria and left hemiparesis of sudden onset. Diffusion-weighted magnetic resonance imaging (MRI) demonstrated a diffusion-restricted lesion in the right corona radiata. Therefore, he was initially diagnosed with lacunar infarction. However, subsequent computed tomographic angiography showed an AVM with calcification in the right corpus callosum and cingulate gyrus. Additional MRI sequences revealed chronic ischemic lesions exclusively in the right cerebral hemisphere. In addition, Technetium-99m-ethyl cysteinate dimer single-photon emission computed tomography showed diffuse hypoperfusion in the right cerebral hemisphere. Thus, hypoperfusion associated with vascular steal could have contributed to the development of the lesion, although our patient might have been predisposed to “lacunar” infarct due to hypertension.
키워드
Cerebral infarction; Arteriovenous malformations; Hemodynamics; Steal
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