Related Experiment Video
Updated: Dec 10, 2025
14:58
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
10.1K
Arteriovenous malformation presenting as traumatic subdural hematoma: A case report
Matthew Parr1, Nitesh Patel1, John Kauffmann1
1Department of Neurological Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Surgical Neurology International
|September 3, 2020
Summary
A subdural hematoma in an anticoagulated patient expanded, leading to seizures and intraparenchymal hemorrhage, revealing an underlying brain arteriovenous malformation (AVM). This case highlights the need to suspect AVMs in unexplained intracranial bleeding, even after trauma.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Neurology
Background:
- Brain arteriovenous malformations (AVMs) are congenital vascular anomalies.
- Hemorrhage is a common presentation of AVMs, often intraparenchymal, subarachnoid, or intraventricular.
- Subdural hematomas are a rare initial presentation of AVMs.
Observation:
- A 66-year-old male on apixaban presented with a small subdural hematoma after a fall.
- The hematoma expanded, requiring evacuation, followed by seizures and subsequent intraparenchymal hemorrhage.
- Catheter angiography revealed a right frontal AVM, treated with embolization and resection.
Findings:
- The patient experienced recurrent intracranial hemorrhages, initially presenting as subdural and later as intraparenchymal.
- A previously undiagnosed brain arteriovenous malformation was identified as the underlying cause.
- Despite neurological deficits, the patient showed some signs of recovery post-treatment.
Implications:
- This case underscores the importance of considering underlying vascular lesions in patients with intracranial bleeding, even with a history of trauma.
- A high index of suspicion for AVMs is crucial, particularly when hematomas expand or present atypically.
- Prompt diagnosis and treatment of AVMs are essential for managing intracranial hemorrhage and improving patient outcomes.
