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De Novo Arteriovenous Malformation in a 4 Year-Old Boy with Headache, with No Previous Cerebrovascular Disease

Laura K Markham and Milo A Hollingworth

Intracerebral arteriovenous malformations (AVM) have traditionally been considered congenital lesions. This model of pathogenesis has recently been challenged following a small number of reports describing de novo presentation of AVM in patients with pre-existing cerebrovascular disease. However, we present the case of a 4 year-old boy presenting with headache, with no history of cerebrovascular disease, whose imaging demonstrated a Spetzler- Martin grade 3 AVM in the left superior temporal gyrus. The patient was previously investigated for seizures as a neonate and at this time magnetic resonance imaging identified no underlying abnormality. We present a case of de novo AVM in a child without pre-existing cerebrovascular disease, adding to a limited number of pre-existing reports and discuss it in context of recent advances in the understanding of AVM pathogenesis.