title: Arteriovenous malformations that rupture during pregnancy: a management dilemma.
abstract: Intracranial haemorrhage due to rupture of an arteriovenous malformation (AVM) during pregnancy is a rare but serious condition that warrants prompt recognition. Once the diagnosis is made, the management is primarily based on neurosurgical rather than obstetric considerations. Due to its rarity, no definitive guidelines exist, and the best time to perform elective surgery (i.e., at presentation or at completion of the pregnancy) is ill-defined. This report describes three patients recently treated at our institution who had AVMs that ruptured during pregnancy. These cases well summarize the difficulties encountered in treating such patients. The diagnostic as well as the therapeutic implications of this condition are discussed.
authors.affiliation: Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville.
authors.forename: G
authors.initials: G
authors.lastname: Lanzino
authors.forename: M E
authors.initials: ME
authors.lastname: Jensen
authors.forename: B
authors.initials: B
authors.lastname: Cappelletto
authors.forename: N F
authors.initials: NF
authors.lastname: Kassell
mesh_terms: D000293:Adolescent; D000328:Adult; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000601:surgery*; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000601:surgery; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D010166:Palliative Care; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000601:surgery*; D011256:Pregnancy Outcome; D016634:Radiosurgery; D014057:Tomography, X-Ray Computed