Intracranial vascular malformations, that includes arteriovenous malformations and cavernous malformations, are the most common cause of intracerebral hemorrhage in young adults. Seizures related to cavernous malformations seems to be attributable to surrounding hemosiderin deposition through leaky endothelial junctions. The estimated risk of occurrence of seizures in patients with vascular malformations is 1.5% per person-year of observation. Lesionectomy (excision of the vascular malformation) versus adjacent epileptogenic corticectomy studies have found lesionectomy enough to relieve the patient of the medically refractory epilepsy with class 1 Engels scale [4] outcome and is safer in eloquent areas of brain [3]. We present three interesting cases of vascular malformations with rare presentations and their surgical management. Vascular malformations presenting as refractory seizures is not a rare entity. Lesionectomy should be the management of choice in these patients in accessible lesions as it can lead to good outcome in terms of seizure outcome in these patients.

Keywords: Seizures; Arteriovenous malformations; lesionectomy.