Ruptured tectal arteriovenous malformation demonstrated angiographically after removal of an unruptured occipital lobe arteriovenous malformation

Fuminari Komatsu, Seisa Burou Sakamoto, Yusuke Takemura, Masani Nonaka, Mika Ohta, Shinya Oshiro, Hitoshi Tsugu, Takeo Fukushima, Tooru Inoue

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

We report a case of ruptured tectal arteriovenous malformation (AVM) that was demonstrated an-giographically only after removal of an unruptured occipital AVM. A 57-year-old man presented with sudden onset of diplopia and tinnitus. Computed tomography revealed a small hemorrhage in the right tectum mesencephali with intraventricular hemorrhage. Magnetic resonance imaging and angiography disclosed AVM in the right occipital lobe which was separate from the hemorrhagic lesion. An-giography demonstrated that the right occipital AVM was fed by the parieto-occipital artery and drained into the superior sagittal sinus and vein of Galen. However, no abnormal vascular lesion was detected near the tectum mesencephali. As venous hypertension was considered the reason for hemorrhage, the occipital AVM was completely resected. Postoperative angiography demonstrated disappearance of the occipital AVM, but it also disclosed a small tectal AVM fed by branches from the superior cerebellar artery, which had not been detected on preoperative angiography. This was considered the true cause of hemorrhage, and gamma knife surgery was accordingly performed. Even if an AVM is demonstrated, if the lesion does not correspond to the hemorrhage we recommend serial angiographical evaluation so that a small AVM is not missed.

Original languageEnglish
Pages (from-to)30-32
Number of pages3
Journalneurologia medico-chirurgica
Volume49
Issue number1
DOIs
Publication statusPublished - 2009
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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