Elderly Man with headaches

An 80 year old gentleman presented with occipito nuchal throbbing headaches of six weeks duration and blurring of vision . On trying to get details of blurring of vision he would mention both eyes but not clearly in any specific field defects type. No vomiting or blurring of vision .
Examination normal Field testing very difficult clinically as his responses were not quite accurate and he was hard of hearing .


MR clearly shows evidence of an AVM

T2WI clearly shows flow voids and large veinous drainage and an old occipital infarct.Angiogram shows a cluster of vessels in the right occipital region .

AVMs generally present with seizures , bleed or headaches but quite unusual at this age ( He is 80 years old ) and hence the post