J Korean Neurosurg Soc.  2009 May;45(5):300-302. 10.3340/jkns.2009.45.5.300.

Severe Symptomatic Vasospasm following Intraventricular Hemorrhage from Arteriovenous Fistula

• Park BS
• Won YS
• Choi CS
• Kim BM

• KMID: 1495121
• DOI: http://doi.org/10.3340/jkns.2009.45.5.300

Abstract

The authors present a rare case of severe vasospasm following the rupture of arteriovenous fistula. On initial CT scan, hematoma in the corpus callosum and left inferior frontal region with surrounding cerebromalacia and all ventricles without apparent subarachnoid hemorrhage were seen. Angiograms showed arterivenous fistula but did not show cerebral vasospasm. Thirteen days after admission the neurological state of patient suddenly deteriorated and bilateral motor weaknesses developed. Following angiograms revealed severe narrowing on the supraclinoid portion of bilateral internal carotid arteries, bilateral anterior cerebral arteries and bilateral middle cerebral arteries. Transluminal angioplasty and intra-arterial papaverine infusion were performed. The patient remained stable with moderate neurologic deficits.

Keyword

Vasospasm; Intraventricular hemorrhage; Arteriovenous fistula

MeSH Terms

Angioplasty
Anterior Cerebral Artery
Arteriovenous Fistula
Carotid Artery, Internal
Corpus Callosum
Encephalomalacia
Fistula
Hematoma
Hemorrhage
Humans
Middle Cerebral Artery
Neurologic Manifestations
Papaverine
Rupture
Subarachnoid Hemorrhage
Vasospasm, Intracranial
Papaverine