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Updated: Mar 17, 2026

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
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.
Introduction:
Some micro arteriovenous malformations (AVMs) located in deep brain are undetectable. How to choose a proper timing to detect these AVMs remains unclear.
Case Description:
A 21-year-old male patient was admitted to our center for intraventricular haematoma. Digital subtraction angiographies (DSAs) were performed one week and one month respectively after his haemorrhage, but no positive results were obtained. The patient was hospitalized for re-haemorrhage six years later. A micro AVM with two diffused niduses was detected and embolised three months after his re-haemorrhage. The patient recovered without any neurological deficit.
Discussion And Evaluation:
Compressive effects of haematoma and spontaneous obliteration of AVMs might play pivotal roles in negative DSA results.
Conclusions:
Strategic and timely use of DSA could identify some dormant re-haemorrhagic AVMs.
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.
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