Postoperative hyperperfusion associated with steal phenomenon caused by a small arteriovenous malformation.
A 41-year-old woman presented with a small occipital arteriovenous malformation (AVM) manifesting as headache. Cerebral angiography showed an AVM in the right occipital lobe fed by the right temporooccipital artery and draining into the superior sagittal sinus and right transverse sinus. Single photon emission computed tomography showed the steal phenomenon in the ipsilateral temporal cortex fed by the main feeding artery preoperatively, and hyperperfusion in the same cortex after removal of the AVM. Postoperative systolic blood pressure was maintained between 100 and 120 mmHg to avoid disastrous hemorrhagic complications. Cerebral blood flow evaluation before and after surgery is important to avoid postoperative disastrous complications even in patients with small AVM.
Nakagawa
Ichiro
I
Department of Neurosurgery, Nara Medical University.
Kawaguchi
Shoichiro
S
Iida
Junichi
J
Hirabayashi
Hidehiro
H
Sakaki
Toshisuke
T
D000328:Adult; D001810:Blood Volume; D002533:Cerebral Angiography; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000601:surgery*; D009778:Occipital Lobe / Q000098:blood supply*; D013702:Temporal Lobe / Q000098:blood supply; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed