Successful surgical removal of a large arteriovenous malformation in a patient with hemophilia: case report.
OBJECTIVE
This is the first reported case of the successful surgical removal of a large arteriovenous malformation (AVM) in a patient with hemophilia A.


METHODS
A 19-year-old male patient was admitted to our department with intracranial hemorrhage. He had previously been diagnosed with hemophilia A and a cerebral AVM. Carotid angiography revealed a large AVM in the right temporal and parietal lobes. The neurological and neuroradiological findings, especially those of single photon emission computed tomography, identified an area of devitalization around the lesion, which was thought to reduce the risk of new deficits resulting from surgical manipulation.


METHODS
We resected the AVM in conjunction with supplemental infusions of Factor VIII before, during, and after the operation. A slight cerebral hemorrhage on the 7th postoperative day was observed despite control with Factor VIII, but the patient was discharged without any new deficits.


CONCLUSIONS
We evaluated and managed all problems of a patient with multiple complications and achieved a medical cure.
Nakau
H
H
Department of Neurosurgery, National Defense Medical College, Tokorozawa, Japan.
Maruishi
M
M
Takiguchi
H
H
Shima
K
K
D000328:Adult; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000517:prevention & control; D005169:Factor VIII / Q000627:therapeutic use; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000601:surgery*; D007430:Intraoperative Care; D008297:Male; D010296:Parietal Lobe / Q000098:blood supply / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care; D013702:Temporal Lobe / Q000098:blood supply / Q000601:surgery; D015899:Tomography, Emission-Computed, Single-Photon
D005169:Factor VIII