[Multiple arteriovenous malformations of left parietal lobe and left cerebellar hemisphere with symptomatic...

The authors described a case of multiple arteriovenous malformations of the left parietal lobe and the left cerebellar hemisphere, and presented a review of literature. A 42-year-old right-handed man was admitted to our Dept. of Neurosurgery on October 20, 1983, with left facial pain and occipitalgia. He had an episode of subarachnoid hemorrhage ten years ago, however, its etiology was not clear at neurological examination. This brief episode of pain began on the left side of his face about 9 years ago and has been gradually increasing. Although he has been treated with trigeminal nerve blocks several times, relapses were almost always evident within 6 months after those nerve blocks. On admission, there were no abnormal findings at neurological and physical examination. A CT scan with contrast medium infusion revealed two small AVMs on the left parietal region and on the left cerebellar hemisphere. A four-vessels cerebral angiogram confirmed the presence of two AVMs and fenestration of the left vertebral artery. The angiogram also revealed that his severe left trigeminal neuralgia had been caused by elongation of the anterior pontine segment of left SCA which was the main feeder of the cerebellar AVM. Two stages of surgical operations were carried out at two months interval. The first operation was total removal of the cerebellar AVM and microvascular decompression for the left trigeminal nerve. The second was total removal of the left parietal AVM. The postoperative course was uneventful, and angiographically the AVMs completely disappeared. The patient was discharged without any neurological deficits on March 11, 1984.(ABSTRACT TRUNCATED AT 250 WORDS)