title: Multiple arteriovenous malformations with hemorrhage.
abstract: BACKGROUND
  A rare case of a left temporal arteriovenous malformation (AVM) with bleeding 10 days after removal of another hemorrhagic AVM in the frontal lobe is reported.
  
  
  METHODS
  A 47-year-old man had an attack of headache and vomiting and was admitted to our hospital. On admission, a CT scan showed subcortical hemorrhage in the left frontal lobe. Left carotid angiography revealed four AVMs and a vertebro-basilar angiogram demonstrated a vascular malformation.
  
  
  RESULTS
  First, a hemorrhagic AVM was removed with a hematoma. Following the operation, left carotid angiograms continued to show, AVMs, particularly a temporal AVM with increased blood flow, and after 10 days this hemorrhaged. This was surgically resected and the remaining small AVMs were treated by stereotactic radiosurgery.
  
  
  CONCLUSIONS
  The patient had a high risk of hemorrhage. Adding hemodynamic stress to this situation, hemorrhage would have been expected to occur at an early time after the initial intervention for hemorrhagic AVM. Considering the risk of hemorrhage, other AVMs should undergo surgery as soon as possible after resection of hemorrhagic AVM.
authors.affiliation: Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara City, Kanagawa, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Utsuki
authors.forename: A
authors.initials: A
authors.lastname: Kurata
authors.forename: Y
authors.initials: Y
authors.lastname: Miyasaka
authors.forename: M
authors.initials: M
authors.lastname: Takano
authors.forename: H
authors.initials: H
authors.lastname: Ootaka
authors.forename: K
authors.initials: K
authors.lastname: Fujii
mesh_terms: D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000473:pathology; D005625:Frontal Lobe / Q000473:pathology*; D006439:Hemodynamics; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013702:Temporal Lobe / Q000473:pathology