Case 35 History ---- The patient is a 38-year-old woman with a past medical history asthma, hypertension and obesity who was initially noted to have progressive vision changes beginning in October 2025, along with new complaints of headaches and bilateral intermittent tinnitus. MRI shows an approximately 3.9 cm serpiginous lesion with flow voids and blooming artifact on SWI in the right inferior frontal lobe and operculum, with arterial supply predominantly from branches of the right MCA and, to a lesser extent, the posterior choroidal artery, as well as superficial drainage to overlying cortical veins and deep drainage via medullary and subependymal veins to the right internal cerebral vein, radiologically consistent with an AVM. CTA shows a right frontal arteriovenous malformation supplied by branches of the right middle cerebral artery, with both superficial and deep venous drainage, and a nidus measuring up to 2.9 cm. ---- 35A1 This FLAIR MRI exam shows the distinctive appearance of the AVM.
