We report the case of a 38-year-old female with alcohol-related cirrhosis who developed a de novo left hemispheric sylvian fissure pial arteriovenous malformation (AVM) causing recurrent hemorrhages, ultimately necessitating neurosurgical intervention. The case underscores the interplay between chronic systemic disease and vascular abnormalities. We explore the theory of de novo brain AVM (bAVM) formation in the context of liver cirrhosis, chronic inflammation and pro-angiogenic conditions thus shedding a light on the potential underlying pathological mechanisms of bAVM formation. This case also highlights the challenges of managing concurrent neurovascular and systemic conditions.
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