Progressive bilateral homonymous visual field defects caused by a left hemisphere arteriovenous malformation: Resolution after embolization

Intracranial supratentorial arteriovenous malformations (AVMs) cause neurologic and visual deficits by a variety of mechanisms, mainly hemorrhage and seizures, but also compression, and, rarely, ischemia. In most cases, the deficits are on the side opposite the malformation. We present the case of a patient with a left hemisphere AVM who developed bilateral homonymous visual field defects. The patient subsequently underwent two embolizations of the AVM using N-butyl cyanoacrylate glue, resulting in almost complete resolution of the visual field defects. We conclude that some supratentorial AVMs produce visual and neurologic deficits by secondary effects on the contralateral hemisphere. In such cases, treatment of the AVM may result in resolution of the deficits.