Arteriovenous malformation

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Clinical History: 
22 year old man with left sided sensory seizures. The seizures are of focal onset, typically affecting the left arm and shoulder, with radiation to the entire left side within 2-3 seconds. He describes the seizures as an electric burning feeling that “is not pain”.

Diagnosis:
Arteriovenous malformation

MR Technique: 
3T (Siemens Verio) with head coil. Image 1: Axial T1 ( TR/TE 250/2.5, slice thickness 4 mm, scan time 2 min 8 sec); Image 2: Axial T1 after injection of 0.1 mmol/kg of gadolinium chelate (TR/TE 250/2.5, slice thickness 4 mm, scan time 2 min 8 sec); Image 3: Coronal T2 (TR/TE 6350/96, slice thickness 4 mm, scan time 1 min 16 sec); Image 4: three dimensional time of flight MRA (TR/TE 21/3.6, slice thickness 0.5 mm, scan time 6 min 56 sec).

Imaging Findings:
Round 3.2 cm lesion is seen in the right temporoparietal white matter, with multiple flow voids in T2 and T1 weighted sequences, which enhances in the post contrast T1 images. This lesion has no mass effect. The MRA has an enlarged right MCA, third portion of the middle cerebral artery and a lenticulostriate artery feeding a nidus of vessels at the previously described location. It also shows an enlarged superficial cortical draining vein.