Abstract
Objectives: To describe the clinical and neuroimaging characteristics, and the association between lesion location and size and seizure type, in patients with cerebral arteriovenous malformation (AVM) presenting with epilepsy. Methods: A retrospective, cross-sectional descriptive study of 42 patients with cerebral arteriovenous malformation (AVM) and seizures, treated at the Institute of Neurology, Bach Mai Hospital, from January 2025 to June 2026 (data cutoff: June 20, 2026). Results: Focal seizures accounted for 85,7% of cases, with focal-to-bilateral tonic-clonic seizures being the most common subtype (45,2%). Headache was the most frequent presenting symptom (50,0%), followed by vomiting (19,0%) and motor deficit ( 19,0%). Multilobar AVMs were the most common location (31,0%), followed by the temporal lobe (26.2%) and frontal lobe (23.8%). AVMs measuring 3-6 cm in diameter were the most prevalent (64,3%). The majority of AVMs measured ≥3 cm (76.2%). Cortical AVMs represented 83,3% of cases and were predominantly associated with focal seizures (91,4%), whereas subcortical AVMs, although comprising only 16,7% of cases, were associated with a higher proportion of generalized seizures. Conclusions: Clinical manifestations were diverse, with headache being the most common symptom, and focal-to-bilateral tonic-clonic seizures predominating among seizure types. Imaging characteristics also varied widely in terms of lesion location and size, with multilobar AVMs accounting for the highest proportion, cortical AVMs being the most common location and mainly presenting with focal seizures clinically, and the majority of AVMs measured ≥3 cm in diameter.
