An Enlarging Intraventricular Arteriovenous Malformation

Abstract

A case is presented in which an enlargement of an intraventricular arteriovenous malformation (AVM) was noted over the period of two years. The patient, a 15-year-old male, was first admitted in December 1980, at the age of 13 years, when he had a sudden onset of headache. Computed tomography (CT) scan showed an intraventricular hemorrhage. Cerebral angiography revealed a small AVM in the left frontal lobe. He was treated conservatively and discharged. In October 1981, the patient was readmitted because of a recurrent intraventricular hemorrhage and was treated conservatively. The third admission was at the age of 15, in November 1982, at which time he suffered again from the intraventricular hemorrhage seen on CT scan. Cerebral angiography showed an enlarged AVM which was supplied by one of the medial lenticulostriate arteries. A right frontotemporal craniotomy was performed in December 1982. As the initial step, the feeding artery was clipped and the AVM located in the wall of the left frontal horn was completely resected microscopically through the transcallosal approach. The histological examination showed a typical AVM. Transcallosal surgery is a useful approach for lesions in the anterior ventricular system. It is assumed that the enlargement of the AVM occurred in the periventricular area which was weakened in resistance by recurrent hemorrhages. No neuropsychological complications were encountered following the section of the anterior part of the corpus callosum.