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We report the case of a patient with a large left subfrontal arteriovenous malformation (AVM) that was supplied by the right internal carotid artery. The anomalous blood supply developed because of complete occlusion of the left internal carotid artery. When the AVM was removed, the patient experienced a hemorrhage into the right basal ganglia. The possibility that this hemorrhage was related to a defect of autoregulation in blood vessels that lie proximal to a large AVM is discussed. Even though this is a unique case, the pathophysiological events that are documented are relevant to the preoperative preparation and surgical management of all patients with AVMs.
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Solomon et al. (1984) studied this question.
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