title: Thoracolumbar Arteriovenous Malformations Presenting with Intracranial Subarachnoid Hemorrhage: Case Series and Review of Literature.
abstract: OBJECTIVE
  Cryptogenic intracranial subarachnoid hemorrhage accounts for approximately 15% of all subarachnoid hemorrhage cases. Diagnostic workup after negative cerebral digital subtraction angiogram typically includes magnetic resonance imaging of the brain and cervical spine for arteriovenous malformations, tumors, and fistulae. Only a few cases of thoracolumbar spinal vascular malformations have been associated with intracranial subarachnoid hemorrhage.
  
  
  METHODS
  Case series and review of the literature.
  
  
  RESULTS
  We found 3 patients at our institution who had nontraumatic, nonaneurysmal intracranial subarachnoid hemorrhage with isolated spinal vascular malformation in the thoracolumbar region. Including our 3 cases, we found a total of 15 similar cases in the literature. Most of the patients were younger, most having concurrent spinal cord symptoms of radiculopathy (27%), myelopathy (20%), or bladder bowel involvement (20%). Most of the spinal vascular malformations were intramedullary or conus medullaris type. Locations of intracranial subarachnoid hemorrhage were mostly isolated to the perimesencephalic area and posterior fossa.
  
  
  CONCLUSIONS
  In younger populations presenting with nonaneurysmal intracranial subarachnoid hemorrhage and symptoms related to the spinal cord, evaluation for thoracolumbar spinal vascular malformations must be included in the initial workup.
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA. Electronic address: russellcerejo@gmail.com.
authors.forename: Russell
authors.initials: R
authors.lastname: Cerejo
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Seby
authors.initials: S
authors.lastname: John
authors.affiliation: Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Grabowski
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bauer
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Burhan
authors.initials: B
authors.lastname: Chaudhry
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Gabor
authors.initials: G
authors.lastname: Toth
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Hui
authors.affiliation: Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Bain
mesh_terms: D000328:Adult; D001165:Arteriovenous Malformations / Q000150:complications* / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D013116:Spinal Cord / Q000002:abnormalities* / Q000098:blood supply* / Q000473:pathology; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000175:diagnosis*; D013904:Thoracic Vertebrae / Q000002:abnormalities; D055815:Young Adult
keywords: Myelopathy; Nonaneurysmal subarachnoid hemorrhage; Thoracolumbar spinal vascular malformations