Cerebral arteriovenous malformation presenting ... - Wiley Online Library

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Ocular examination showed a left hemianopia, left optic atrophy, and ... left eye, a best corrected visual acuity of 6/60 in the right eye, ... Right orbital ultrasound.
Case report

Cerebral arteriovenous malformation presenting as visual deterioration in a child Lesley C Kaye MRC Ophth, Associate Specialist in Ophthalmology; Stephen B Kaye* MD FRCOphth, Consultant Ophthalmologist; Ruby Lagnado FRCOphth, Specialist Registrar in Ophthalmology; Anne Boothroyd FRCR, Consultant Radiologist; Clare Morton FRCOphth, Senior Registrar in Ophthalmology; Paul May FRCS, Consultant Neurosurgeon, Royal Liverpool Children’s Hospital, Eaton Road, Alder Hey, Liverpool, UK. *Correspondence to second author at Department of Ophthalmology, Royal Liverpool Children’s Hospital, Eaton Road, Alder Hey, Liverpool L12 2AP, UK.

A rare case of visual loss as the presenting feature of a central arteriovenous malformation involving the vein of Galen is reported. A 5-year-old girl with a history of deteriorating vision for the past 6 months was examined. Ocular examination showed a left hemianopia, left optic atrophy, and dilated vessels of the right optic disc. MRI revealed a massive deep-seated central arteriovenous malformation involving the vein of Galen. The mechanism of visual loss is likely to be a combination of ischaemic optic atrophy associated with a steal phenomenon and direct compression of the right optic radiation.

Vascular malformations of the brain are rare and potentially life-threatening, with aneurysms of the vein of Galen representing