Occipital lobe arteriovenous malformations. Clinical and radiologic features in 26 cases with comments on differentiation from migraine
B. T. Troost and T. H. Newton
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.
