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CASE REPORT
Year : 1982  |  Volume : 30  |  Issue : 3  |  Page : 155-156

Arteriovenous malformation of brain and eye


Department of Ophthalmology, V.S.S. Medical College, Burla, India

Correspondence Address:
I M Sahoo
Department of Ophthalmology, V.S.S. Medical College, Burla
India
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Source of Support: None, Conflict of Interest: None


PMID: 7174061

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How to cite this article:
Sahoo I M, Sahoo R N, Das B S. Arteriovenous malformation of brain and eye. Indian J Ophthalmol 1982;30:155-6

How to cite this URL:
Sahoo I M, Sahoo R N, Das B S. Arteriovenous malformation of brain and eye. Indian J Ophthalmol [serial online] 1982 [cited 2020 Jul 6];30:155-6. Available from: http://www.ijo.in/text.asp?1982/30/3/155/28197

Cerebral and ocular angiomatous malfor­mations are of three definite types, i.e., Capi­llary angiomas (Telangiectasis), venous angiomas and arterio-venous malformations. Arterio-venous malformation comprises 0.8% in 600 cases of brain tumor studied by Dandy[1]. Arterio-venous malformations of eye and brain are very uncommon.[2],[3]. We are reporting here a case of malformation of brain and eye because of its rare occurrence.


  Case report Top


The patient N.P. of 20 years old was apparently alright 9 years back. Then he developed weakness of left side of the body. The weakness was slowly progressive. He used to get focal Jacksonian convulsions star­ting from left hand and spreading to whole left side without loss of consciousness for last five years. 3 years back he was admitted to psychiatric ward for abnormal behaviour. For last five years he also noticed protrusion of the right eye ball. For 3 years he developed throbbing headache more during night time in the right side.

The patient was of average body built, Pulse-64 per minute and Regular, B.P.­140'64 mm Hg., Higher function -normal, Hemiparesis with hemianesthesia in the left side and left facial nerve palsy of upper motor neurone type, Carotid pulsation visible on right side of the neck, Systolic murmur over right carotid artery, right superficial temporal artery and over right eye ball.

Ocular findings-Nonpulsatile proptosis of right eye with restriction of movement to lateral side [Figure l]. Fundus picture revealed papilloed­ema with haemorrhages Arteries were very much tortuous and veins were extremely dila­ted. There was arterio-venous connection.

VA-L.E. 6/6, R.E. 6/18. Perimetry revealed concentric constriction of right visual field and left field was within normal limit. I.O.P.­L.E. 20.53 mm Hg , R.E. 18.86 mm Hg.

Blood T.L.C.-14,000/Cmm, VDRL-Non­reactive, E.S.R.-38 mm in 1st hour, X'ray of skull-Normal, X'ray of orbit-Normal, X' ray of optic foramen- Normal. Rt carotid angiogram revealed arterio-venous malforma­tion in the middle cerebral artery extending to left side also. Ant. cerebral artery was not visualised [Figure - 1].


  Discussion Top


Angiomas usually occur between the age of 10 to 30 years. Our patient had symptom first at the age of 15 years in the form of weakness of the left side, subsequently developed focal epilepsy, psychiatric problem in the form of abnormal behaviour. For the last 5 years he is having proptosis and headache was of 3 years duration. As quoted by Ross Russel[4] in angiomas, presenting symptoms are epilepsy (41.2%), haemorrhage (39.3%), headache (17.1%)and paresis (2.4%). Although paresis is rare, it was rather predominant presenta­tion in our case. Focal Jacksonian Seizure and paresis in our case can be easily explained by malformations involving the motor cortex. Hemicrania of migrainous character strongly raised the possibility of angioma for our case. Cranial bruit (systolic) which is very diagnostic was present in our case. Bruit was also present over orbit suggesting of Arterio-venous malformation of the orbit. Ophthalmoscopic picture of right eye was also suggestive of arterio-venous malfor­mation of the orbit. Carotid angiogram was very much diagnostic.

 
  References Top

1.
Dandy, W.E., 1928. Arch. Surg. 17 :190.  Back to cited text no. 1
    
2.
Glees, M., 1954, Kiin Monatsble Angenh 124: 451.  Back to cited text no. 2
    
3.
Bregeat, P., David, M. and Fischgold, H., 1952, Proc. Soc. France. Ophthalmol, 65: 77.  Back to cited text no. 3
    
4.
Ross Russel, R.W., 1977, Medicine, 34, 2066.  Back to cited text no. 4
    


    Figures

  [Figure - 1], [Figure - 2]



 

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