Prolonged visual aura, late-onset migraine-like headaches, and seizures suggest an occipital arteriovenous malformation

To report a patient with occipital arteriovenous malformation (AVM), manifested by prolonged visual aura and migraine-like headache as well as rare tonic–clonic seizures. The patient is a 55-year-old woman with a left occipital, unruptured AVM that first manifested with attacks of prolonged visual a...

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Bibliographic Details
Main Authors: Josef Finsterer, Sounira Mehri
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-03-01
Series:Journal of Family Medicine and Primary Care
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Online Access:https://journals.lww.com/10.4103/jfmpc.jfmpc_910_24
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Summary:To report a patient with occipital arteriovenous malformation (AVM), manifested by prolonged visual aura and migraine-like headache as well as rare tonic–clonic seizures. The patient is a 55-year-old woman with a left occipital, unruptured AVM that first manifested with attacks of prolonged visual aura, followed by a migraine-like headache at the age of 32. The frequency of these attacks steadily increased over the years and at the age of 45 she experienced her first tonic–clonic seizure. The workup revealed a left occipital, unruptured AVM. She received levetiracetam (1000 mg/d), which she discontinued at the age of 53. At the age of 54 years, she suffered a second tonic–clonic seizure, but the patient continued to refuse to undergo embolization, resection, or stereotactic radiosurgery. This case demonstrates that an occipital, unruptured AVM can go undetected for years and present with late-onset, migraine-like headaches with prolonged visual aura and rare generalized seizures. Patients with late-onset, migraine-like headaches with prolonged visual aura require immediate brain imaging.
ISSN:2249-4863
2278-7135