A case series of gyrus rectus arteriovenous malformation: Clinical characteristics, angioarchitecture, microsurgical treatment, and outcome

Sadik K Daily; Mustafa Ismail; Alzahraa A Abdulmajeed; Ameer M Aynona; Maliya Delawan; Mostafa H Algabri; Samer S Hoz

doi:10.25259/SNI_433_2023

A case series of gyrus rectus arteriovenous malformation: Clinical characteristics, angioarchitecture, microsurgical treatment, and outcome

Surg Neurol Int. 2023 Jun 23:14:219. doi: 10.25259/SNI_433_2023. eCollection 2023.

Authors

Sadik K Daily¹, Mustafa Ismail², Alzahraa A Abdulmajeed¹, Ameer M Aynona³, Maliya Delawan⁴, Mostafa H Algabri¹, Samer S Hoz⁵

Affiliations

¹ Department of Surgery, College of Medicine, University of Baghdad, Baghdad, Iraq.
² Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq.
³ Department of Surgery, College of Medicine, The University of Babylon, Hillah, Iraq.
⁴ College of Medicine, Gulf Medical University, Ajman, United Arab Emirates.
⁵ Department of Neurosurgery, University of Cincinnati, Cincinnati, United States.

Abstract

Background: Gyrus rectus arteriovenous malformation (AVM) is one of the intricate pathologies that can lead to gyrus rectus hematoma. However, there is a paucity of research on this topic. This case series aims to delineate the characteristics of gyrus rectus AVMs, their outcomes, and treatment strategies.

Methods: We enrolled five cases of gyrus rectus AVM that presented to the Neurosurgery Teaching Hospital in Baghdad, Iraq. Patients with the presence of gyrus rectus AVM were analyzed according to the demographic data, clinical status, radiological imaging, and outcome.

Results: Of the total cases enrolled, all five cases were ruptured at the presentation. Most of the AVMs had arterial feeders from the anterior cerebral artery (80%) and superficial venous drainage through the anterior third of the superior sagittal sinus occurred in four cases (80%). Two of the cases were classified as Spetzler-Martin grade 1 AVMs, two were grade 2, and one was grade 3. With regard to the modified Rankin Score (mRS), four of them had a score of 0 after observation for 30, 18, 26, and 12 months, respectively, while one patient had an mRS score of 1 after 28 months of observation. All five cases presented with seizure and were all treated by surgical resection.

Conclusion: To the best of our knowledge, this is the second report documenting the features of gyrus rectus AVMs and the first one from Iraq. Further, research into gyrus rectus AVMs is required to help better characterize and enhance our knowledge on the outcomes of such lesions.

Keywords: Arteriovenous malformation; Front-basal arteriovenous malformation; Front-basal hemorrhage; Gyrus rectus; Gyrus rectus arteriovenous malformation.