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DOI: 10.1055/s-0029-1220937
© Georg Thieme Verlag KG Stuttgart · New York
Haemorrhage from a Radiosurgically Treated Arteriovenous Malformation after its Angiographically Proven Obliteration: a Case Report
Publication History
Publication Date:
25 November 2009 (online)
![](https://www.thieme-connect.de/media/zblneurochir/201002/lookinside/thumbnails/10.1055-s-0029-1220937-1.jpg)
Abstract
Small lower-grade Spetzler-Martin arteriovenous malformations (AVMs) are mainly treated by microsurgical resection or stereotactic radiosurgery. The choice of treatment largely depends on the referring centre's preference and the patient's decision. We present here a patient with an AVM repeatedly treated at our Leksell Gamma Knife unit with radiographically confirmed obliteration of the AVM which subsequently began bleeding. This case demonstrates the possibility of late complications in radiosurgically treated AVMs even after their demonstrable obliteration. Meticulous histological examination was performed, proving patency of the AVM nidus. The risk of haemorrhagic complications of radiosurgically removed AVMs despite angiographic proof of their obliteration is, in our view, a cogent argument for preferring surgical resection if the AVM is accessible and for prolonged follow-up after radiosurgical treatment of an AVM.
Key words
pial AVM - stereotactic radiosurgery - nidus obliteration - rupture
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Correspondence
Dr. O. Bradáč
Department of Neurosurgery
UVN Central Military Hospital
Charles University 1st Medical Faculty
U Vojenské nemocnice 1200
Prague
Czech Republic
169 02
Phone: +420/973/202 963
Fax: +420/973/202 963
Email: ondrej.bradac@uvn.cz