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Fig 4. Parietal high-flow AVM with deep and bilateral cortical drainage.
A–D, Frontal left internal carotid angiogram, early and late phase, before and after the second embolization. Patent venous drainage is seen after the treatment.
E–L, Axial MR (E–H, T1-weighted, and I–L, DWI [b 1000]) immediately posttreatment, at 23 days, 35 days after treatment, and before a third treatment, 3 months later. The images illustrate the development of venous thrombosis 3 weeks after treatment in the deep and contralateral cortical veins with a complete resolution at follow-up.
M–U, rCBF (M–O) and rCBV (P–R) with the corresponding MTT (S–U): unchanged PI images after treatment (left column) are followed by a dramatic increase in MTT (severe drop in rCBF with a mild rCBV increase) 3 weeks later (middle column). A slow but almost total normalization of PI pattern was seen 9 days later (ie, after hypervolemic hemodilution) (right column). The patient was left with no symptoms.
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