{"id":"3d2667d6-e9f3-4b6d-aa92-9d9af72840ed","slug":"glioblastoma-with-pseudo-arteriovenous-malformation-features-combined-arterial-spin-labeling-assessment-and-preoperative-embolization","title":"Glioblastoma with pseudo-arteriovenous malformation features: Combined arterial spin-labeling assessment and preoperative embolization","authors":["Elena Filimonova","Pavel Trukhachev","Anton Kalinovsky","Artem Perfilev","Alexey Sosnov","Jamil Rzaev"],"abstract":"Background: Glioblastoma (GBM) may occasionally present with prominent vascular features that mimic an arteriovenous malformation (AVM), leading to diagnostic and therapeutic challenges. Pseudo-AVM GBMs are rare, and their recognition is essential to avoid misdiagnosis and inappropriate management. Case Description: We report a 67-year-old male with a 2-month history of progressive headache, memory impairment, and speech difficulties. Neurological examination demonstrated mild right-sided limb weakness, homonymous hemianopsia, and expressive aphasia. Brain magnetic resonance imaging (MRI), computed tomography angiography, and digital subtraction angiography revealed a left temporal GBM with AVM-like vascular features. Arterial spin labeling (ASL) perfusion MRI revealed marked hyperperfusion and early venous drainage, providing noninvasive confirmation of tumor-related shunting. To reduce intraoperative bleeding risk, partial preoperative embolization of feeding arteries from the middle cerebral artery was performed, followed by gross total microsurgical resection. Histopathological examination demonstrated a hypervascular GBM, isocitrate dehydrogenase (IDH)-wildtype, with microvascular proliferation and necrosis confirmed by immunohistochemistry and polymerase chain reaction. Postoperative recovery was uneventful, and adjuvant chemoradiation according to the Stupp protocol was recommended. Conclusion: This case highlights pseudo-AVM GBM as a diagnostic and therapeutic challenge and demonstrates the value of ASL perfusion MRI and presurgical embolization in selected hypervascular tumors.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/3d2667d6-e9f3-4b6d-aa92-9d9af72840ed/featured/hero-1781557789326.png","publishDate":"2026-03-20T00:00:00.000Z","doi":"10.25259/SNI_1267_2025","categories":["Neuro-oncology","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/3d2667d6-e9f3-4b6d-aa92-9d9af72840ed/pdf"}