DOI: 10.36347/sjmcr.2018.v06i09.018

Pages: 676-678

The intracranial hypertension (ICH) is an unusual consequence of the unruptured arteriovenous malformation (AVM), only 13 cases are described in the literature. We report in this observation a case of unruptured AVM revealed by a spontaneous cerebrospinal fluid (CSF) rhinorrhea due ICH. It is about a 46-year-old patient, presenting a rhinorrhea installed in a progressive way for 2 years associated to occipital headaches. The MRI objectified a wide CSF leakage of the sphenoïdal sinus associated with a voluminous frontal AVM. The arteriography confirmed the diagnosis. The initial therapeutic decision consisted of a ventriculo-peritoneale drainage, and a supervision of the AVM. The evolution was marked by the obstinacy of the rhinorrhea, and the surgical management of the AVM was decided. After the surgery, the patient reports the regression of the rhinorrhea and headache. In the literature, the ICH sees itself at young patient with broadband AVM with deep sinus drainage. The mechanism is unknown, it’s not resolved by medical treatment, and the treatment of the AVM by surgery, radiosurgery or embolisation remains the treatment of choice.