Mohd Tahir, Fadzillah and Ishak, Siti Raihan and Wan Hitam, Wan Hazabbah
(2013)
Arteriovenous Malformation in Temporal Lobe Presenting as Contralateral Ocular Symptoms Mimicking Carotid-Cavernous Fistula.
Case Reports in Ophthalmological Medicine, 2013 (158961).
pp. 1-3.
ISSN 2090-6722
Abstract
To report a rare case of arteriovenousmalformation in temporal lobe presenting as contralateral orbital symptoms mimicking
carotid-cavernous fistula. Method. Interventional case report. Results. A 31-year-old Malay gentleman presented with 2-month
history of painful progressive exophthalmos of his left eye associated with recurrent headache, diplopia, and reduced vision. Ocular
examination revealed congestive nonpulsating 7mmexophthalmos of the left eye with no restriction of movements in all direction.
There was diplopia in left lateral gaze. Left IOP was elevated at 29mmHg. Left eye retinal vessels were slightly dilated and tortuous.
CT scan was performed and showed right temporal arteriovenous malformation with a nidus of 3.8 cm× 2.5 cm with right middle
cerebral artery as feeding artery. There was dilated left superior ophthalmic vein of 0.9mmin diameter with enlarged left cavernous
sinus. MRA and carotid angiogram confirmed right temporal arteriovenous malformation with no carotid-cavernous fistula.Most
of the intracranial drainage was via left cavernous sinus. His signs and symptoms dramatically improved following successful
embolisation, completely resolved after one year. Conclusion. Intracranial arteriovenous malformation is rarely presented with
primary ocular presentation. Early interventionwould salvage the eyes and prevent patients frommore disastermorbidity or fatality
commonly due to intracranial haemorrhage.
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