|Year : 1982 | Volume
| Issue : 3 | Page : 155-156
Arteriovenous malformation of brain and eye
IM Sahoo, RN Sahoo, BS Das
Department of Ophthalmology, V.S.S. Medical College, Burla, India
I M Sahoo
Department of Ophthalmology, V.S.S. Medical College, Burla
Source of Support: None, Conflict of Interest: None
|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
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. Arterio-venous malformations of eye and brain are very uncommon.,. We are reporting here a case of malformation of brain and eye because of its rare occurrence.
| Case report|| |
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|| |
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 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|| |
Dandy, W.E., 1928. Arch. Surg. 17 :190.
Glees, M., 1954, Kiin Monatsble Angenh 124: 451.
Bregeat, P., David, M. and Fischgold, H., 1952, Proc. Soc. France. Ophthalmol, 65: 77.
Ross Russel, R.W., 1977, Medicine, 34, 2066.
[Figure - 1], [Figure - 2]