Dormant micro arteriovenous malformations lead to recurrent cerebral haemorrhage

Jun Cai1, Hao Lin1, Shaoxue Li1

  • 1Department of Neurosurgery, Hospital of Guangzhou University Mega Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510006 China.

Springerplus
|July 28, 2016
PubMed
Abstract

Insights

Detecting deep brain arteriovenous malformations (AVMs) can be challenging. Strategic timing of digital subtraction angiography (DSA) can reveal dormant, re-hemorrhagic AVMs missed in initial assessments.

Area of Science:

  • Neurology
  • Radiology
  • Neurosurgery

Background:

  • Deep brain micro arteriovenous malformations (AVMs) are often undetectable.
  • Optimal timing for AVM detection remains unclear.

Purpose of the Study:

  • To investigate the diagnostic challenges and timing for detecting deep brain AVMs.
  • To highlight the potential for delayed diagnosis of re-hemorrhagic AVMs.

Main Methods:

  • A case study of a 21-year-old male with intraventricular hemorrhage.
  • Serial digital subtraction angiographies (DSAs) performed at one week and one month post-hemorrhage showed no AVM.
  • Diagnosis and embolization of a micro AVM occurred three months after re-hemorrhage six years later.

Main Results:

  • Initial DSAs were negative, likely due to compressive effects of hematoma and spontaneous AVM obliteration.
  • Delayed DSA after re-hemorrhage successfully identified the micro AVM.
  • The patient recovered fully without neurological deficits.

Conclusions:

  • Strategic and timely use of DSA is crucial for identifying dormant, re-hemorrhagic AVMs.
  • Delayed imaging may be necessary for diagnosing certain AVMs presenting with hemorrhage.