Intraventricular hemorrhage secondary to ruptured arteriovenous malformation: A case report

Abstract

Introduction: An arteriovenous malformation (AVM) is a lesion in which the feeding artery and the draining vein are connected by a coiled, tortuous vascular link. This nidus is where arteriovenous shunting occurs. While pediatric AVM is uncommon, there has been evidence of possible impairments and an increased risk of hemorrhage. This study aimed to elaborate on a rare case of pediatric arteriovenous malformation with intraventricular hemorrhage. Case report: A male patient, fifteen years of age, was referred from P hospital due to a severe headache that was accompanied by nausea and vomiting two days prior to hospital admission. Chief Computed Tomography Digitizing and Angiographic Images In the left lateral ventricle, the posterior horn of the right lateral ventricle, the third ventricle, and the left pericallosal area AVM (Spletzer Martin grading: 2), intraventricular hemorrhage (IVH), and moderate cerebral edema were all seen during an angiography. AVM was managed conservatively with head positioning 30o, analgesics, and ranitidine. Phenytoin was given as a precaution for seizure in intracerebral hemorrhage. The headache improved gradually during the hospital stay. Upon follow-up at the outpatient clinic, headache and other neurological symptoms were absent, and the patient had typical vital signs. Conclusion: AVM rupture can cause IVH that occurs more often in young patients. Management of pediatric AVM requires discussion among pediatric neurologists, neurosurgeons, and interventional radiologists to decide the best care for the patient. AVM patients who received conservative treatment had a higher risk of bleeding and, therefore, required routine monitoring.