Cerebral intraventricular hemorrhage caused by a large cerebral arteriovenous malformation at 31 years after diagnosis.
Cerebral arteriovenous malformation (AVM) has an overall 2% to 4% annual risk of hemorrhage. The annual risk of hemorrhage does not decrease with age. However, the natural history of non-operative AVM is difficult to follow up consistently for more than 30 years. In this report, we present a case with a large cerebral AVM which developed a major bleeding causing intraventricular hemorrhage (IVH) 31 years after the diagnosis. A male patient was proved to have a cerebral AVM in the right corpus callosum by cerebral angiography at ages 20 and 28. He was found losing consciousness due to rupture of AVM with IVH at age 51. A small cerebral aneurysm and a dilated vein (aneurysm) of Galen were noted also. A craniotomy with removal of the hematoma and microsurgical resection of the AVM was performed immediately, and the patient regained normal respiration and consciousness about 2 months and 7 months after craniotomy, respectively. We recommend that neurosurgeons should play active roles in encouraging young patients with large AVMs to receive microsurgical resection.
Wang
Y C
YC
Department of Neurosurgery, Taichung Veterans General Hospital, 160, Taichung-Kang Road, Sec. 3, Taichung 407, Taiwan. ycwang@vghtc.vghtc.gov.tw
Lee
S D
SD
Chen
N F
NF
Shen
C C
CC
D000367:Age Factors; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D002552:Cerebral Ventricles; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013997:Time Factors