{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T05:27:39Z","timestamp":1773466059057,"version":"3.50.1"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"13","license":[{"start":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T00:00:00Z","timestamp":1695600000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,25]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Brain arteriovenous malformations (AVMs) usually manifest as hemorrhages or seizures. They rarely present with ischemic symptoms, especially in young patients. We present a case of an epileptogenic AVM that led to cerebral infarction due to paradoxical embolic occlusion of the middle cerebral artery (MCA) involving the main feeder of the lesion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 35-year-old male had been suffering from AVM-associated epilepsy for 10 years and was scheduled for surgery. He suddenly developed right-sided hemiconvulsions followed by hemiparalysis and impaired consciousness. Computed tomography revealed no intracerebral hemorrhage, and symptoms were initially thought to indicate epilepsy and Todd\u2019s palsy. Because of his prolonged symptoms, he underwent magnetic resonance imaging, which revealed a large cerebral infarction due to occlusion of the MCA involving the main feeder of the AVM. The patient underwent AVM resection, and the partially thrombosed nidus was completely removed. Histopathological investigation revealed a fresh thrombus in totally occluded nonarteriosclerotic feeders. He had no atrial fibrillation; however, subsequent transesophageal echocardiography revealed a patent foramen ovale, suggesting a paradoxical embolism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case serves as a reminder that AVMs can present with considerable variability. Acute cerebral infarction should be considered a possible mechanism of seizures, even in patients with epileptogenic AVM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23432","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T21:18:34Z","timestamp":1695676714000},"source":"Crossref","is-referenced-by-count":3,"title":["Ischemic stroke in a young adult with a known epileptogenic arteriovenous malformation: illustrative case"],"prefix":"10.3171","volume":"6","author":[{"given":"Seiji","family":"Kuribara","sequence":"first","affiliation":[{"name":"Departments of Cerebrovascular Surgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuma","family":"Maeda","sequence":"additional","affiliation":[{"name":"Departments of Cerebrovascular Surgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taro","family":"Yanagawa","sequence":"additional","affiliation":[{"name":"Departments of Cerebrovascular Surgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eisuke","family":"Tsukagoshi","sequence":"additional","affiliation":[{"name":"Endovascular Neurosurgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Kohyama","sequence":"additional","affiliation":[{"name":"Endovascular Neurosurgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Kurita","sequence":"additional","affiliation":[{"name":"Departments of Cerebrovascular Surgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"J Neurosurg","first-page":"633","article-title":"Population-based analysis of arteriovenous malformation treatment","volume":"95","author":"Hillman J","year":"2001","unstructured":"Hillman J. Population-based analysis of arteriovenous malformation treatment. J Neurosurg. 2001;95(4):633\u2013637."},{"issue":"12","key":"b2","series-title":"Neurol Med Chir (Tokyo)","first-page":"899","article-title":"Progression of stenosis into occlusion of the distal posterior cerebral artery supplying an occipital arteriovenous malformation manifesting as multiple ischemic attacks: case report","volume":"52","author":"Goto H","year":"2012","unstructured":"Goto H, Suzuki M, Akimura T,  Progression of stenosis into occlusion of the distal posterior cerebral artery supplying an occipital arteriovenous malformation manifesting as multiple ischemic attacks: case report. Neurol Med Chir (Tokyo). 2012;52(12):899\u2013902."},{"issue":"14","key":"b3","series-title":"Med Clin (Barc)","first-page":"558","article-title":"A cerebral infarct associated with a giant cerebral arteriovenous malformation","volume":"104","author":"Vericat MC","year":"1995","unstructured":"Vericat MC, Arboix A, Massons J, Targa C. A cerebral infarct associated with a giant cerebral arteriovenous malformation. Article in Spanish. Med Clin (Barc). 1995;104(14):558."},{"issue":"7","key":"b4","series-title":"Neurol Med Chir (Tokyo)","first-page":"417","article-title":"Embolic stroke in the territory of a cerebellar arteriovenous malformation--case report","volume":"38","author":"Komiyama M","year":"1998","unstructured":"Komiyama M, Nakajima H, Nishikawa M, Yasui T. Embolic stroke in the territory of a cerebellar arteriovenous malformation--case report. 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