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Updated: May 24, 2026

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

Vasospasm after arteriovenous malformation rupture.

Bradley A Gross¹, Rose Du

¹Department of Neurological Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.

World Neurosurgery

|March 3, 2012

Summary

Vasospasm after brain arteriovenous malformation (AVM) rupture is rare, even with subarachnoid hemorrhage (SAH). Delayed cerebral ischemia (DCI) is uncommon, and routine angiography for vasospasm is not recommended in these patients.

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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage

Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage

Published on: August 30, 2020

Area of Science:

Neurology
Neurosurgery
Radiology

Background:

Delayed cerebral ischemia (DCI) and vasospasm are significant complications following aneurysmal subarachnoid hemorrhage (SAH).
Brain arteriovenous malformations (AVMs) are a less common cause of SAH, and the incidence of associated vasospasm is not well-established.

Observation:

A review of 122 patients with AVMs, including 84 hemorrhages, found no cases of DCI.
Only one patient (1.1%) experienced mild angiographic vasospasm after AVM rupture in the reviewed series.
Literature review identified 19 additional cases of vasospasm after AVM rupture, with a reported incidence of 6.3% in some series.

Findings:

Angiographic vasospasm following AVM rupture, even with SAH, is infrequent.
The majority of AVM hemorrhages had an intraparenchymal component, with a significant proportion also involving intraventricular or subarachnoid spaces.
Patients experiencing vasospasm after AVM rupture were younger on average and had a higher incidence of intraventricular hemorrhage.

Implications:

Routine, empiric delayed angiography to screen for vasospasm in patients with AVM rupture is not recommended.
Vasospasm remains a rare but possible complication and should be considered in patients presenting with DCI after AVM rupture.