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Journal of Korean Neurosurgical Society > Volume 45(5); 2009 > Article
Journal of Korean Neurosurgical Society 2009;45(5): 300-302.
doi: https://doi.org/10.3340/jkns.2009.45.5.300
Severe Symptomatic Vasospasm following Intraventricular Hemorrhage from Arteriovenous Fistula.
Beom Seok Park, Yu Sam Won, Chun Sik Choi, Byung Moom Kim
1Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. yusam.won@samsung.com
2Department of Diagnostic Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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.
Key Words: Vasospasm; Intraventricular hemorrhage; Arteriovenous fistula
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