Cerebral arteriovenous malformations (cAVMs) are congenital vascular lesions associated with clinical manifestations such as intracerebral hemorrhage, seizures, neurological deficits, and migraines. Diagnosis typically relies on imaging modalities such as digital subtraction angiography (DSA), magnetic resonance imaging (MRI), and computed tomography (CT). Treatment options include conservative management, microsurgical resection, stereotactic radiosurgery, endovascular embolization, or multimodal approaches. We present the case of a pediatric patient with an intracranial hemorrhage caused by a ruptured cAVM which was discovered intraoperatively, and we evaluate her postoperative course and long-term outcomes. A 10-year-old girl presented to the emergency department after losing consciousness at home. CT revealed an intracerebral hematoma. Progressive enlargement of the hematoma over the following hours resulted in neurological and systemic deterioration. An emergency temporoparietal craniotomy was performed, during which a cAVM was identified and successfully excised. Postoperatively, the patient demonstrated gradual neurological improvement. At six months of follow-up, she showed sustained neurological recovery. Although intracranial hemorrhages can often be reliably managed with surgical evacuation, the intraoperative discovery of an underlying cAVM presents significant challenges, as it alters the scope of the intervention and increases operative risk. Further studies are needed to assist neurosurgeons in managing these rare but high-risk scenarios, with the goal of minimizing morbidity.
Иванов et al. (Sat,) studied this question.