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

## TL;DR

A rare case of a bone-based blood vessel abnormality in the temporal bone caused drug-resistant seizures in a young man, successfully treated with surgery.

## Contribution

This case report highlights a rare presentation of intraosseous AVM in the temporal bone and its successful surgical management.

## Key findings

- A 19-year-old male with drug-resistant seizures was diagnosed with an intraosseous AVM in the temporal bone.
- Surgical resection of the lesion resulted in complete resolution of seizures and no neurological deficits.
- Intraoperative pathological investigation confirmed the diagnosis of AVM.

## 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.