Symptomatic cerebral vasospasm after intraventricular hemorrhage from ruptured arteriovenous malformation

1992 ◽  
Vol 38 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Kiyoyuki Yanaka ◽  
Akio Hyodo ◽  
Yukihiro Tsuchida ◽  
Yoshihiko Yoshii ◽  
Tadao Nose
Keyword(s):  
Arteriovenous Malformation ◽  
Cerebral Vasospasm ◽  
Intraventricular Hemorrhage

Successful treatment of severe cerebral vasospasm following hemorrhage of an arteriovenous malformation

2009 ◽  
Vol 4 (3) ◽  
pp. 266-269 ◽  
Author(s):  
Arjun V. Pendharkar ◽  
Raphael Guzman ◽  
Robert Dodd ◽  
David Cornfield ◽  
Michael S. B. Edwards
Keyword(s):  
Differential Diagnosis ◽  
Arteriovenous Malformation ◽  
Cerebral Vasospasm ◽  
Balloon Angioplasty ◽  
Cerebral Angiography ◽  
Intraventricular Hemorrhage ◽  
Mr Angiography ◽  
Neurological Deficits ◽  
Aggressive Treatment ◽  
Initial Recovery

The authors describe the case of a 13-year-old boy who presented with an intraventricular hemorrhage caused by a left trigonal arteriovenous malformation. After an initial recovery, the patient experienced complete right-sided paresis on posthemorrhage Day 6. Severe cerebral vasospasm was found on MR angiography and confirmed on conventional cerebral angiography. Intraarterial nicardipine injection and balloon angioplasty were successfully performed with improved vasospasm and subsequent neurological recovery. Cerebral vasospasm should be considered in the differential diagnosis for neurological deterioration following an arteriovenous malformation hemorrhage, and aggressive treatment can be administered to prevent ischemia and further neurological deficits.

scholarly journals Isolated Intraventricular Hemorrhage Associated with Cerebral Vasospasm and Delayed Cerebral Ischemia following Arteriovenous Malformation Rupture

2018 ◽  
Vol 7 (6) ◽  
pp. 479-489 ◽  
Author(s):  
Krishna Amuluru ◽  
Fawaz Al-Mufti ◽  
Charles E. Romero ◽  
Chirag D. Gandhi
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Arteriovenous Malformation ◽  
Cerebral Angiography ◽  
Intraventricular Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Statistical Significance ◽  
Delayed Cerebral Ischemia ◽  
Ruptured Avm ◽  
Level Of Significance

Background: Although it is well characterized in aneurysmal subarachnoid hemorrhage, vasospasm is exceedingly rare following cerebral arteriovenous malformation (AVM) rupture. Subsequently, this complication is poorly characterized with regard to delayed cerebral ischemia (DCI). We review cases of ruptured AVM to assess the frequency and severity of vasospasm on cerebral angiography, and DCI. Summary: We reviewed our institutional database of acute intracranial hemorrhages between 2005 and 2014. We identified patients with cerebral AVM rupture and evidence of vasospasm, which was confirmed with digital subtraction angiography (DSA). Cerebral angiograms were evaluated by 2 blinded neurointerventionalists for vasospasm. Statistical analyses were conducted on the angiographic results and variables of interest to determine predictors and associations of vasospasm and DCI. Thirty-six patients with acute intracranial hemorrhage due to ruptured cerebral AVM subsequently underwent cerebral angiography. The interrater reliability for vasospasm was 0.81. The incidence of vasospasm was 13.9% and the incidence of subsequent DCI was 11.1%. A significant relationship existed between isolated intraventricular hemorrhage and vasospasm (p = 0.001) and subsequent DCI (p = 0.006). Radiographic vasospasm was associated with DCI in 80% of the patients (p < 0.0001). No statistical significance existed between subarachnoid hemorrhage and the development of vasospasm or DCI (p = 1.000 and p = 0.626, respectively). All differences were significant at a 99% level of significance. Key Message: In cases of ruptured AVM, isolated intraventricular hemorrhage appears to be an independent risk factor for vasospasm and DCI. Vasospasm must be considered during late neurological deterioration following AVM hemorrhage, especially in the setting of isolated intraventricular hemorrhage.

scholarly journals Isolated fourth ventricle haemorrhage: “think beyond intracranial source’’ unusual presentation of lumbosacral spine arteriovenous malformation presentation

2019 ◽  
pp. 59-62
Author(s):  
Naresh Panwar ◽  
Manish Agrawal ◽  
Ghanshyam Agrawal ◽  
V. D. Sinha
Keyword(s):  
Arteriovenous Malformation ◽  
Fourth Ventricle ◽  
Intraventricular Hemorrhage ◽  
Spinal Column ◽  
Sudden Onset ◽  
Severe Headache ◽  
Vascular Lesions ◽  
Lumbosacral Spine ◽  
Isolated Fourth Ventricle ◽  
Spinal Arteriovenous Malformations

Spinal arteriovenous malformations (SAVMs) are rare vascular lesions and account for about 4% of primary intraspinal masses. Since SAVMs can involve any location along the spinal column and produce a host of different problems, the symptoms are extremely variable. There are few reports of simultaneous cerebral SAH and intraventricular hemorrhage (IVH) following rupture of a spinal AVM (SAVMs). Herein, we present a rare case of Lumbo Sacral spine arteriovenous malformation, which clinically manifests as sudden onset of severe headache and vomiting due to isolated fourth ventricle Hemorrhage (IVH) without cerebral subarachnoid hemorrhage.

scholarly journals Usefulness of Direct and Neuroendoscopic Surgery for Ruptured Arteriovenous Malformation with Massive Intraventricular Hemorrhage

2018 ◽  
Vol 46 (1) ◽  
pp. 65-70
Author(s):  
Shinichi SHIRAKAMI ◽  
Masanori TSUJIMOTO ◽  
Tatsuki AKI ◽  
Naoki OKA ◽  
Takayuki KATO ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Intraventricular Hemorrhage ◽  
Neuroendoscopic Surgery

Terson syndrome caused by intraventricular hemorrhage associated with arteriovenous malformation: Case report

2020 ◽  
Author(s):  
F. Villamil ◽  
M. Ruella ◽  
S.J.M. Giovannini ◽  
T. Ries Centeno ◽  
F. Marco Del Pont ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Malformation ◽  
Intraventricular Hemorrhage ◽  
Terson Syndrome

Recombinant Tissue Plasminogen Activator in the Treatment of Intraventricular Hemorrhage Secondary to Periventricular Arteriovenous Malformation before Surgery: Case Report

Neurosurgery ◽  
2003 ◽  
Vol 52 (4) ◽  
pp. 964-969 ◽  
Author(s):  
Krishna Kumar ◽  
Denny D. Demeria ◽  
Ashok Verma
Keyword(s):  
Magnetic Resonance ◽  
Arteriovenous Malformation ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Intraventricular Hemorrhage ◽  
Surgical Intervention ◽  
Obstructive Hydrocephalus ◽  
External Ventricular Drain ◽  
Recombinant Tissue Plasminogen Activator ◽  
Tissue Plasminogen

Abstract OBJECTIVE AND IMPORTANCE Intraventricular hemorrhage (IVH) is known to cause acute obstructive hydrocephalus, refractory elevated intracranial pressures (ICPs), and lowered cerebral perfusion pressures, leading to cortical ischemia. Frequent obstruction of external ventricular drains as a result of thrombus is a recurring theme. We present a case of IVH secondary to periventricular arteriovenous malformation (AVM) that was not visible at admission angiography and was treated by intraventricular infusion of recombinant tissue plasminogen activator before surgical intervention. CLINICAL PRESENTATION An 11-year-old boy presented with acute onset of headache followed by two seizures, loss of consciousness, decerebration, right temporal hematoma, IVH, and acute obstructive hydrocephalus. INTERVENTION A right external ventricular drain was placed but functioned poorly. ICP could not be controlled by conventional methods. Five milligrams of recombinant tissue plasminogen activator was injected into the ventricular system via the external ventricular drain. This was repeated daily for 4 days. This treatment resulted in progressive improvement in ICP and clinical status. Once the clot partially cleared, magnetic resonance imaging and magnetic resonance angiography suggested the presence of a right periventricular arteriovenous malformation, which was confirmed by angiography and subsequently resected. CONCLUSION Recombinant tissue plasminogen activator is effective in resolving IVH causing obstructive hydrocephalus and uncontrollable ICP posing a life-threatening situation, secondary to ruptured arteriovenous malformation, before surgical intervention.

scholarly journals Acute surgery for a case of superior vermian arteriovenous malformation producing raised venous pressure coexisting with basilar-superior cerebellar artery aneurysm presenting subarachnoid hemorrhage; Case report

2021 ◽  
Vol 12 ◽  
pp. 23
Author(s):  
Sho Tsunoda ◽  
Tomohiro Inoue ◽  
Akihiro Shimoi ◽  
Atsuya Akabane
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Arteriovenous Malformation ◽  
Cerebral Vasospasm ◽  
Acute Phase ◽  
Venous Pressure ◽  
Artery Aneurysm ◽  
Superior Cerebellar Artery ◽  
Oculomotor Palsy ◽  
Acute Surgery ◽  
Cerebellar Artery

Background: Superior vermian subtype of arteriovenous malformation (AVM) coexisting with proximal feeder aneurysm on basilar-superior cerebellar artery (BA-SCA) junction is an extremely rare situation. We experienced a case of this rare entity presenting with subarachnoid hemorrhage (SAH), and herein, introduce the outline and clinical features of this experience together with the actual surgical video. Case Description: A 54-year-old man SAH patient with severe headache, disturbance of consciousness, and left oculomotor palsy was urgently admitted to our hospital. Imaging examination demonstrated superior vermian AVM with BA-SCA aneurysm, and both lesions were treated through two different approaches (left pterional craniotomy in conjunction with zygomectomy, and left posterior interhemispheric occipital transtentorial approach) in acute phase of SAH. Both lesions were completely disappeared postoperatively and the patient’s postoperative course was favorable, without symptomatic cerebral vasospasm. Although slight oculomotor palsy remained, the patient recovered well and was transferred to a rehabilitation hospital for further improvement. Conclusion: In the cases of AVM coexisting with proximal feeder aneurysm, presenting with SAH, disorders of intracranial venous return associated with an AVM can be a vital hindrance to managing cerebral vasospasm; therefore, treating both lesions in the acute phase may lead to good outcomes.

Extensive Cerebral Arteriovenous Malformation-Associated Intraventricular Hemorrhage

2021 ◽  
pp. 194187442110490
Author(s):  
Amine Awad ◽  
Kow Essuman ◽  
Robert W. Regenhardt ◽  
Thabele M. Leslie-Mazwi ◽  
Aman B. Patel ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Intraventricular Hemorrhage ◽  
Cerebral Arteriovenous Malformation
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