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Occipital Lobe Arteriovenous Malformations: Clinical and Radiologic Features in 26 Cases With Comments on Differentiation From Migraine

Occipital Lobe Arteriovenous Malformations: Clinical and Radiologic Features in 26 Cases With... Abstract The differentiation of migraine headache, preceded by visual aura, from cerebral arteriovenous malformation (AVM) is often regarded as difficult. A study of 26 patients with occipital lobe AVM revealed two distinct syndromes in 18 patients—occipital epilepsy and occipital apoplexy. Occipital epilepsy is characterized either by elementary visual phenomena, such as brief flashes of light, or by dimming of a homonymous field. Occipital apoplexy results from hemorrhage and hematoma formation within the occipital lobe and is characterized by sudden headache and homonymous visual field loss. We conclude that patients harboring occipital AVMs may, indeed, have visual phenomena and headache that should not be confused with migraine because either a history of generalized seizure or bruits on examination will probably be present. References 1. Olivecrona H, Ladenheim J: Congenital Arteriovenous Aneurysms of the Carotid and Vertebral Arterial Systems . Berlin, Springer-Verlag, 1957. 2. Adie WJ: Permanent hemianopia in migraine and subarachnoid haemorrhage . Lancet 2:237-238, 1930.Crossref 3. Mackenzie I: The clinical presentation of the cerebral angioma: A review of 50 cases . Brain 76:184-214, 1953.Crossref 4. Dimsdale H: Discussion on the neuro-ophthalmological aspects of the cerebral angiomas . Proc R Soc Med 50:85-88, 1957. 5. Lees F: The migrainous symptoms of cerebral angiomata . J Neurol Neurosug Psychiatr 25:45-50, 1962.Crossref 6. Connor RCR: Complicated migraine: A study of permanent neurological and visual defects cause by migraine . Lancet 2:1072-1075, 1962.Crossref 7. Potter JM: Angiomatous malformations of the brain: Their nature and prognosis . Ann R Coll Surg Eng 16:227-243, 1955. 8. Paterson JH, McKissock W: A clinical survey of intracranial aneurysms with special reference to their mode of progression and surgical treatment: A report of 110 cases . Brain 79:233-266, 1956.Crossref 9. Sabra J: Observations on 100 cases of cerebral angioma . JAMA 170:1522-1524, 1959.Crossref 10. Sutton D: Discussion on the neuro-ophthalmological aspects of the cerebral angiomas . Proc R Soc Med 50:91-92, 1957. 11. Ozer MN, Sencer W, Block J: A clinical study of cerebral vascular malformations: The significance of migraine . J Mt Sinai Hosp 31:403-423, 1964. 12. Walsh FB, Hoyt WF: Clinical Neuro-ophthalmology , ed 3. Baltimore, Williams & Wilkins, 1969. 13. Bradshaw P, Parsons M: Hemiplegic migraine: A clinical study . Q J Med 34:65-85, 1965. 14. Rabe W: Die indikation zu neuroradiologischen Untersuchungen bei Migrane . Fortschr Neurol Psychiatr 39:401-411, 1971. 15. Sacks OW: Migraine: Evolution of a Common Disorder . Los Angeles, University of California Press, 1970, p 125. 16. Russell WR, Whitty CWM: Studies in traumatic epilepsy: 3. Visual fits . J Neurol Neurosurg Psychiatr 18:79-96, 1955.Crossref 17. Marques Assis L, Livarmento JA, Cury M: Estudo clinico de 68 casos de epilepsia occipital . Arq Neuropsiquiatr 29:49-54, 1971.Crossref 18. Brindley GS, Lewin WS: The sensations produced by electrical stimulation of the visual cortex . J Physiol 196:479-493, 1968. 19. Brindley GS, Donaldson PEK, Falconer MA, et al: The extent of the region of occipital cortex that when stimulated gives phosphenes fixed in the visual field . J Physiol 225:57-58P, 1972. 20. Enoksson P, Bynke H: Visual field defects in arteriovenous aneurysms of the brain . Acta Ophthalmol 36:586-600, 1958.Crossref 21. Penfield W, Jasper HH: Epilepsy and the Functional Anatomy of the Human Brain . Boston, Little Brown & Co, 1954. 22. Gassel MM: Occipital lobe syndromes (excluding hemianopia) , in Vinken PJ, Bruyn GS (eds): Handbook of Clinical Neurology . Amsterdam, North-Holland Publishing Co, 1969, vol 2, pp 640-679. 23. Kooi KA: Episodic blindness as a late effect of head trauma: Electrophysiological study of three cases . Neurology 20:569-573, 1970.Crossref 24. Von Rad M: Ein Fall von isoliertem epileptischem Nystagmus . Dtsch Z Nervenheilkd 197:125-132, 1970.Crossref 25. Waltimo 0: The relationship of size, density, and localization of intracranial arteriovenous malformations to the type of initial symptom . J Neurol Sci 19:13-19, 1973.Crossref 26. Heyck M: Pathogenesis of migraine , in Friedman AP (ed): Research and Clinical Studies in Headache . New York, S Karger, 1969, vol 2, pp 1-28. 27. Prosenz P, Heiss WD, Kvicala V, et al: Contribution to the hemodynamics of arterial venous malformations . Stroke 2:279-289, 1971.Crossref 28. Feindel W, Yamamoto YL, Hodge CP: Red cerebral veins and the cerebral steal syndrome: Evidence from fluorescein angiography and microregional blood flow by radioisotopes during excision of an angioma . J Neurosurg 35:167-179, 1971.Crossref 29. Streeter GL: The developmental alterations in the vascular system of the brain of the human embryo . Contrib Embryol 8:7-38, 1918. 30. Olivecrona H, Riives J: Arteriovenous aneurysms of the brain: Their diagnosis and treatment . Arch Neurol Psychiatr 59:567-602, 1948.Crossref 31. Kaplan HA, Aronson SM, Browder EJ: Vascular malformations of the brain: An anatomical study . J Neurosurg 18:630-635, 1961.Crossref 32. Teuber HL, Battersby WS, Bender MB: Visual Field Defects after Penetrating Missile Wounds of the Brain . Cambridge, Mass, Harvard University Press, 1960. 33. Weiskrantz L, Cowey A: Comparison of the effects of striate cortex and retinal lesions on visual acuity in the monkey . Science 155:104-106, 1967.Crossref 34. Hoyt WF: Vascular lesions of the visual cortex with brain herniation through the tantorial incisura: Neuro-ophthalmologic considerations . Arch Ophthalmol 64:44-57, 1960.Crossref 35. von Monakow C: Die Lokalisation im Grosshirn und der Abbau der Funktion durch kortikale Herde . Weisbaden, JF Bergmann, 1914. 36. Meyer JS, Shinohara Y, Kanda T, et al: Diaschisis resulting from acute unilateral cerebral infarction: Quantitative evidence for man . Arch Neurol 23:241-247, 1970.Crossref 37. Geschwind N: Disconnection syndromes in animals and man: I . Brain 88:237-294, 1965.Crossref 38. Critchley M: Metamorphopsia of central origin . Trans Ophthalmol Soc UK 69:111-121, 1949. 39. Kestenbaum A: Clinical Methods of Neuro-ophthalmologic Examination , ed 2. New York, Grune & Stratton, 1961. 40. Daroff RB, Hoyt WF: Supranuclear disorders of the ocular control systems in man: Clinical, anatomical, and physiological correlations, 1969 , in Bach-y-Rita, Collins CC, Hyde JE (eds): The Control of Eye Movements . New York, Academic Press, 1971, pp 175-235. 41. Troost BT, Daroff RB, Weber RB, et al: Hemispheric control of eye movement: II. Quantitative analysis of pursuit in a hemispherectomy patient . Arch Neurol 27:449-452, 1972.Crossref 42. Cogan DG: Neurologic significance of lateral conjugate deviation of the eyes on forced closure of the lids . Arch Ophthalmol 39:37-42, 1949.Crossref 43. Smith JL, Gay AJ, Cogan DG: The spasticity of conjugate gaze phenomenon . Arch Ophthalmol 62:694-696, 1959.Crossref 44. Boyd-Wilson JS: The association of cerebral angiomas with intracranial aneurysms . J Neurol Neurosurg Psychiatr 22:218-223, 1959.Crossref 45. Anderson RMcD, Blackwood W: The association of arteriovenous angioma and saccular aneurysm of the arteries of the brain . J Pathol Bacteriol 77:101-110, 1959.Crossref 46. Conqvist S, Troupp H: Intracranial arteriovenous malformation and arterial aneurysm in the same patient . Acta Neurol Scand 42:307-316, 1966.Crossref 47. Newton TH, Troost BT: Arteriovenous malformations and fistulae , in Newton TH, Potts GD (eds): Radiology of the Skull and Brain . St. Louis, CV Mosby Co, 1973, chap 83, pp 2490-2565. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Occipital Lobe Arteriovenous Malformations: Clinical and Radiologic Features in 26 Cases With Comments on Differentiation From Migraine

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References (54)

Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1975.01010020260002
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Abstract

Abstract The differentiation of migraine headache, preceded by visual aura, from cerebral arteriovenous malformation (AVM) is often regarded as difficult. A study of 26 patients with occipital lobe AVM revealed two distinct syndromes in 18 patients—occipital epilepsy and occipital apoplexy. Occipital epilepsy is characterized either by elementary visual phenomena, such as brief flashes of light, or by dimming of a homonymous field. Occipital apoplexy results from hemorrhage and hematoma formation within the occipital lobe and is characterized by sudden headache and homonymous visual field loss. We conclude that patients harboring occipital AVMs may, indeed, have visual phenomena and headache that should not be confused with migraine because either a history of generalized seizure or bruits on examination will probably be present. References 1. Olivecrona H, Ladenheim J: Congenital Arteriovenous Aneurysms of the Carotid and Vertebral Arterial Systems . Berlin, Springer-Verlag, 1957. 2. Adie WJ: Permanent hemianopia in migraine and subarachnoid haemorrhage . Lancet 2:237-238, 1930.Crossref 3. Mackenzie I: The clinical presentation of the cerebral angioma: A review of 50 cases . Brain 76:184-214, 1953.Crossref 4. Dimsdale H: Discussion on the neuro-ophthalmological aspects of the cerebral angiomas . Proc R Soc Med 50:85-88, 1957. 5. Lees F: The migrainous symptoms of cerebral angiomata . J Neurol Neurosug Psychiatr 25:45-50, 1962.Crossref 6. Connor RCR: Complicated migraine: A study of permanent neurological and visual defects cause by migraine . Lancet 2:1072-1075, 1962.Crossref 7. Potter JM: Angiomatous malformations of the brain: Their nature and prognosis . Ann R Coll Surg Eng 16:227-243, 1955. 8. Paterson JH, McKissock W: A clinical survey of intracranial aneurysms with special reference to their mode of progression and surgical treatment: A report of 110 cases . Brain 79:233-266, 1956.Crossref 9. Sabra J: Observations on 100 cases of cerebral angioma . JAMA 170:1522-1524, 1959.Crossref 10. Sutton D: Discussion on the neuro-ophthalmological aspects of the cerebral angiomas . Proc R Soc Med 50:91-92, 1957. 11. Ozer MN, Sencer W, Block J: A clinical study of cerebral vascular malformations: The significance of migraine . J Mt Sinai Hosp 31:403-423, 1964. 12. Walsh FB, Hoyt WF: Clinical Neuro-ophthalmology , ed 3. Baltimore, Williams & Wilkins, 1969. 13. Bradshaw P, Parsons M: Hemiplegic migraine: A clinical study . Q J Med 34:65-85, 1965. 14. Rabe W: Die indikation zu neuroradiologischen Untersuchungen bei Migrane . Fortschr Neurol Psychiatr 39:401-411, 1971. 15. Sacks OW: Migraine: Evolution of a Common Disorder . Los Angeles, University of California Press, 1970, p 125. 16. Russell WR, Whitty CWM: Studies in traumatic epilepsy: 3. Visual fits . J Neurol Neurosurg Psychiatr 18:79-96, 1955.Crossref 17. Marques Assis L, Livarmento JA, Cury M: Estudo clinico de 68 casos de epilepsia occipital . Arq Neuropsiquiatr 29:49-54, 1971.Crossref 18. Brindley GS, Lewin WS: The sensations produced by electrical stimulation of the visual cortex . J Physiol 196:479-493, 1968. 19. Brindley GS, Donaldson PEK, Falconer MA, et al: The extent of the region of occipital cortex that when stimulated gives phosphenes fixed in the visual field . J Physiol 225:57-58P, 1972. 20. Enoksson P, Bynke H: Visual field defects in arteriovenous aneurysms of the brain . Acta Ophthalmol 36:586-600, 1958.Crossref 21. Penfield W, Jasper HH: Epilepsy and the Functional Anatomy of the Human Brain . Boston, Little Brown & Co, 1954. 22. Gassel MM: Occipital lobe syndromes (excluding hemianopia) , in Vinken PJ, Bruyn GS (eds): Handbook of Clinical Neurology . Amsterdam, North-Holland Publishing Co, 1969, vol 2, pp 640-679. 23. Kooi KA: Episodic blindness as a late effect of head trauma: Electrophysiological study of three cases . Neurology 20:569-573, 1970.Crossref 24. Von Rad M: Ein Fall von isoliertem epileptischem Nystagmus . Dtsch Z Nervenheilkd 197:125-132, 1970.Crossref 25. Waltimo 0: The relationship of size, density, and localization of intracranial arteriovenous malformations to the type of initial symptom . J Neurol Sci 19:13-19, 1973.Crossref 26. Heyck M: Pathogenesis of migraine , in Friedman AP (ed): Research and Clinical Studies in Headache . New York, S Karger, 1969, vol 2, pp 1-28. 27. Prosenz P, Heiss WD, Kvicala V, et al: Contribution to the hemodynamics of arterial venous malformations . Stroke 2:279-289, 1971.Crossref 28. Feindel W, Yamamoto YL, Hodge CP: Red cerebral veins and the cerebral steal syndrome: Evidence from fluorescein angiography and microregional blood flow by radioisotopes during excision of an angioma . J Neurosurg 35:167-179, 1971.Crossref 29. Streeter GL: The developmental alterations in the vascular system of the brain of the human embryo . Contrib Embryol 8:7-38, 1918. 30. Olivecrona H, Riives J: Arteriovenous aneurysms of the brain: Their diagnosis and treatment . Arch Neurol Psychiatr 59:567-602, 1948.Crossref 31. Kaplan HA, Aronson SM, Browder EJ: Vascular malformations of the brain: An anatomical study . J Neurosurg 18:630-635, 1961.Crossref 32. Teuber HL, Battersby WS, Bender MB: Visual Field Defects after Penetrating Missile Wounds of the Brain . Cambridge, Mass, Harvard University Press, 1960. 33. Weiskrantz L, Cowey A: Comparison of the effects of striate cortex and retinal lesions on visual acuity in the monkey . Science 155:104-106, 1967.Crossref 34. Hoyt WF: Vascular lesions of the visual cortex with brain herniation through the tantorial incisura: Neuro-ophthalmologic considerations . Arch Ophthalmol 64:44-57, 1960.Crossref 35. von Monakow C: Die Lokalisation im Grosshirn und der Abbau der Funktion durch kortikale Herde . Weisbaden, JF Bergmann, 1914. 36. Meyer JS, Shinohara Y, Kanda T, et al: Diaschisis resulting from acute unilateral cerebral infarction: Quantitative evidence for man . Arch Neurol 23:241-247, 1970.Crossref 37. Geschwind N: Disconnection syndromes in animals and man: I . Brain 88:237-294, 1965.Crossref 38. Critchley M: Metamorphopsia of central origin . Trans Ophthalmol Soc UK 69:111-121, 1949. 39. Kestenbaum A: Clinical Methods of Neuro-ophthalmologic Examination , ed 2. New York, Grune & Stratton, 1961. 40. Daroff RB, Hoyt WF: Supranuclear disorders of the ocular control systems in man: Clinical, anatomical, and physiological correlations, 1969 , in Bach-y-Rita, Collins CC, Hyde JE (eds): The Control of Eye Movements . New York, Academic Press, 1971, pp 175-235. 41. Troost BT, Daroff RB, Weber RB, et al: Hemispheric control of eye movement: II. Quantitative analysis of pursuit in a hemispherectomy patient . Arch Neurol 27:449-452, 1972.Crossref 42. Cogan DG: Neurologic significance of lateral conjugate deviation of the eyes on forced closure of the lids . Arch Ophthalmol 39:37-42, 1949.Crossref 43. Smith JL, Gay AJ, Cogan DG: The spasticity of conjugate gaze phenomenon . Arch Ophthalmol 62:694-696, 1959.Crossref 44. Boyd-Wilson JS: The association of cerebral angiomas with intracranial aneurysms . J Neurol Neurosurg Psychiatr 22:218-223, 1959.Crossref 45. Anderson RMcD, Blackwood W: The association of arteriovenous angioma and saccular aneurysm of the arteries of the brain . J Pathol Bacteriol 77:101-110, 1959.Crossref 46. Conqvist S, Troupp H: Intracranial arteriovenous malformation and arterial aneurysm in the same patient . Acta Neurol Scand 42:307-316, 1966.Crossref 47. Newton TH, Troost BT: Arteriovenous malformations and fistulae , in Newton TH, Potts GD (eds): Radiology of the Skull and Brain . St. Louis, CV Mosby Co, 1973, chap 83, pp 2490-2565.

Journal

Archives of Ophthalmology – American Medical Association

Published: Apr 1, 1975

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