Piotr Bełdziński, Małgorzata Lemka, Ewa Pilarska, Maria Mazurkiewicz-Bełdzińska, Ewa Dilling-Ostrowska, Paweł Słoniewski
CaseRepClinPractRev 2002; 3(4):268-272
Background: Intracranial arteriovenous malformations (AVMs) are congenital lesions, which occur with approximate frequency reaching 1.5% to 3% of the population. In children, hemorrhage is the initial presenting syndrome in 25% cases. In the majority of cases it is a severe intracerebral or intraventricular bleeding without other symptoms. This causes higher mortality rate in this group as compared with adult patients (25% vs. 6–10%). The diagnosis is based on computed tomography (CT), magnetic resonance imaging (MRI) and cerebral angiography (AG). Surgical extirpation of the lesions, embolization or radiosurgery, alone or in combinations, are the methods of choice in therapy.
Case Report: A 10-years-old boy who suffered from three intracerebral bleedings from the arteriovenous malformation located in the occipital lobe is presented. Cerebral angiography performed after the second bleeding, revealed an aneurysm of the posterior right chorioideal artery as the cause of bleedings. The operation was performed with the use of a neuronavigation tool.
Conclusions: The neuronavigation tool gave us the direct view into the location of pathology and enabled us to verify in situ the pre-operative diagnosis – none aneurysm were found The AVM could be totally resected using minimally invasive technique.
Keywords: intracerebral hemorrhage, childhood, arteriovenous malformation, Neuronavigation, computer-assisted