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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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
Subjects:
Online Access:https://journals.lww.com/10.4103/jfmpc.jfmpc_910_24
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author Josef Finsterer
Sounira Mehri
author_facet Josef Finsterer
Sounira Mehri
author_sort Josef Finsterer
collection DOAJ
description 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.
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spelling doaj-art-9d42763d8ee64c2998005f82ab70d6222025-08-20T03:08:24ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632278-71352025-03-011431139114110.4103/jfmpc.jfmpc_910_24Prolonged visual aura, late-onset migraine-like headaches, and seizures suggest an occipital arteriovenous malformationJosef FinstererSounira MehriTo 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.https://journals.lww.com/10.4103/jfmpc.jfmpc_910_24arterio-venous malformationauraepilepsymigraineheadachetonic–clonic seizures
spellingShingle Josef Finsterer
Sounira Mehri
Prolonged visual aura, late-onset migraine-like headaches, and seizures suggest an occipital arteriovenous malformation
Journal of Family Medicine and Primary Care
arterio-venous malformation
aura
epilepsy
migraine
headache
tonic–clonic seizures
title Prolonged visual aura, late-onset migraine-like headaches, and seizures suggest an occipital arteriovenous malformation
title_full Prolonged visual aura, late-onset migraine-like headaches, and seizures suggest an occipital arteriovenous malformation
title_fullStr Prolonged visual aura, late-onset migraine-like headaches, and seizures suggest an occipital arteriovenous malformation
title_full_unstemmed Prolonged visual aura, late-onset migraine-like headaches, and seizures suggest an occipital arteriovenous malformation
title_short Prolonged visual aura, late-onset migraine-like headaches, and seizures suggest an occipital arteriovenous malformation
title_sort prolonged visual aura late onset migraine like headaches and seizures suggest an occipital arteriovenous malformation
topic arterio-venous malformation
aura
epilepsy
migraine
headache
tonic–clonic seizures
url https://journals.lww.com/10.4103/jfmpc.jfmpc_910_24
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AT souniramehri prolongedvisualauralateonsetmigrainelikeheadachesandseizuressuggestanoccipitalarteriovenousmalformation