Clinical features

Arteriovenous malformations are usually clinically silent until an event such as bleeding or epilepsy occurs.

Presentations include:

• intracranial bleeding - more often intracerebral or intraventricular than subarachnoid. Usually in younger people - 20-40 years - than haemorrhage associated with aneurysms.
• seizures - generalised or focal; common especially if it involves the cortical surface
• progressive neurological deficits - often involving the basal ganglia. Presents with hemiparesis, dementia, visual field defects. Motor / sensory defects in absence of cranial nerve involvement due to brainstem AVM - rare.
• headache - may sometimes appear similar to migraine
• transient ischaemic attacks
• cranial bruits - especially over eyeball

Reference

1. Hartmann A, Mohr JP: Acute management of brain arteriovenous malformations. Curr Treat Options Neurol. 2015, 17:346.