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Vascular/Cardiac » Cerebrovascular
Left dural arterio-venous malformation
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Presentation This is the scan of the neck in a 65-year-old woman with complaints of audible bruits in the left ear and papilledema. She has a past history of left Sylvian fissure meningioma.
 
 
 
Caption: Spectral waveforms of both common carotid arteries
Description: The right CCA exhibits normal spectral waveform. The left CCA has a turbulent flow and exhibits high flow velocities [in the range of 180 cm/sec]
 
 
 
Caption: Spectral waveforms of both external carotid arteries
Description: The right ECA demonstrates a normal arterial waveform and flow velocity. The left ECA demonstrates a turbulent flow and elevated flow velocities.
 
 
 
Caption: Spectral waveforms of both internal carotid arteries
Description: Both the internal carotid arteries demonstrate normal spectral waveforms with normal flow velocities.
 
 
 
Caption: Spectral waveforms of both vertebral arteries
Description: Both the vertebral arteries exhibit normal flow velocities. The left vertebral artery however demonstrates a turbulent flow.
 
 
 
Caption: Spectral waveforms of both subclavian arteries
Description: Both the subclavian arteries exhibit a normal spectral waveform with normal flow velocities.
 
Differential Diagnosis Elevated velocities of the left CCA, left ECA suggest an indirect evidence of a left dural arterio-venous malformation
 
Final Diagnosis Left dural arterio-venous malformation
 
Follow Up An angiogram and MRI was performed which showed a left dural arterio-venous malformation.
 
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