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Case Reports
. 2025 May 15:12:1510821.
doi: 10.3389/fsurg.2025.1510821. eCollection 2025.

Case Report: Intraosseous arteriovenous malformation of the temporal bone presenting with drug-resistant seizures

Guive Sharifi  1   2 , Elham Paraandavaji  2 , Bardia Hajikarimloo  2 , Tohid Emami Meybodi  3 , Jina Behjati  2 , Yalda Nilipour  4   5 , Mohammad Ali Kazemi  6   7 , Esmaeil Mohammadi  8 , Sajjad Khanbabazadeh  9
Affiliations
Case Reports

Case Report: Intraosseous arteriovenous malformation of the temporal bone presenting with drug-resistant seizures

Guive Sharifi et al. Front Surg. .

Abstract

Intraosseous arteriovenous malformations (AVMs) are rare conditions characterized by the development of AVMs within bones, leading to a variety of symptoms. Temporal bone AVMs are exceedingly uncommon, as evidenced by the small number of reported instances in the medical literature. A 19-year-old male patient presented with persistent seizures that were unresponsive to pharmacological treatments administered over three years. Imaging revealed a non-enhancing lesion measuring 31 × 22 mm in the right temporal lobe, originating from the middle fossa and the right petrous apex. The patient underwent successful surgical resection of the lesion, with no intraoperative complications or postoperative neurological deficits. Diagnosis of AVM was made after intraoperative pathological investigation. Follow-up examinations showed a complete resolution of the patient's seizures. The management of these lesions is challenging and it requires personalized approaches, which depend on clinical presentation, lesion location, progression, and the patient's overall condition.

Keywords: arteriovenous malformation (AVM); case report; intraosseous; seizures; surgery; temporal bone; temporal bone arteriovenous malformation (AVM).

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Coronal MRI images, post-contrast, show T1 sequence (A) and T2 sequence (B), revealing a large lesion in the right sphenoid bone with intracranial epidural protrusion and an internal flow void, indicative of an AVM.
Figure 2
Figure 2
Post-resection view showing gross-total resection of the intraosseous AVM.
Figure 3
Figure 3
(A–C) Histopathological microscopy (hematoxylin & eosin staining) of the lesion showing proliferative epithelial cells, fibrous tissue, with vascular structures and endothelial cells interspersed among the bone trabeculae indicative of an intraosseous AVM.
Figure 4
Figure 4
Shows a postoperative coronal brain CT angiography of the patient. A right-sided temporal craniotomy is visible. There is a defect and mild irregularity in the superior cortex of the sphenoid bone resulting from surgical resection of the AVM. The tumor and its feeders are completely resected.
See this image and copyright information in PMC

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