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Treatment of arteriovenous malformations associated with ruptured intracranial aneurysm

Le Minh Thang 1
Tran Chi Cuong 1
Nguyen-Dao Nhat Huy 1
Nguyen Luu Giang 1
Nguyen Quang Hung 2
Nguyen Hai Dang 2
Ton Nu Thi Diem 2
Nguyen Trung Tinh 2
Nguyen Minh Duc 3, * ORCID logo
  1. Digital subtraction angiography Unit, Can Tho S.I.S General Hospital, Can Tho, Viet Nam
  2. Department of Surgery, Can Tho S.I.S General Hospital, Can Tho, Viet Nam
  3. Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam
Correspondence to: Nguyen Minh Duc, Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam. ORCID: https://orcid.org/0000-0001-5411-1492. Email: [email protected].
Volume & Issue: Vol. 10 No. 4 (2023) | Page No.: 5614-5618 | DOI: 10.15419/bmrat.v10i4.801
Published: 2023-04-30

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This article is published with open access by BioMedPress. This article is distributed under the terms of the Creative Commons Attribution License (CC-BY 4.0) which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. 

Abstract

Spontaneous subarachnoid hemorrhage (SAH) is a specific characteristic of aneurysmal rupture. SAH coexisting with arteriovenous malformations is challenging to treat because the patient status at admission is severe and the therapeutic approach is multidisciplinary: endovascular treatment, cerebral fluid drainage, and decompressive craniectomy. We report a clinical case successfully treated for cerebellar hemorrhage due to a ruptured aneurysm with arteriovenous malformations. A 65-year-old woman was admitted to Can Tho SIS General Hospital within six hours of stroke onset. She experienced loss of consciousness, aphasia, and high blood pressure. Non-contrast computed tomography showed a diffused SAH in both cerebellum hemispheres, Sylvian fissure, intraventricular hemorrhage, and non-communicating hydrocephalus. Her medical history included uncontrolled hypertension. The patient underwent multidisciplinary treatment for hydrocephalus, cerebellar edema, and embolization to control recurrent ruptured arteriovenous malformations. She recovered well and was discharged on day 30 with a Modified Rankin Scale score of 1.

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