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Case Reports
. 2008 Apr;1(4):316-9.
doi: 10.3171/PED/2008/1/4/316.

Recurrent intracerebral hemorrhage from a cerebral arteriovenous malformation undetected by repeated noninvasive neuroimaging in a 4-year-old boy. Case report

Lori C Jordan  1 , George I Jallo, Philippe Gailloud
Affiliations
Case Reports

Recurrent intracerebral hemorrhage from a cerebral arteriovenous malformation undetected by repeated noninvasive neuroimaging in a 4-year-old boy. Case report

Lori C Jordan et al. J Neurosurg Pediatr. 2008 Apr.

Abstract

The authors report the case of a 4-year-old boy with a spontaneous intracerebral hemorrhage (ICH) related to an arteriovenous malformation (AVM) that was not found with good-quality magnetic resonance (MR) imaging and MR angiography. Both modalities were used serially in the acute phase and at 2 and 7 months of follow-up. Digital subtraction angiography identified the peripheral AVM when the patient experienced rehemorrhaging 1 year after his initial presentation. This case illustrates the need for a complete diagnostic evaluation including conventional angiography in cases of idiopathic ICH in children.

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Figures

Figure 1
Figure 1
Head CT at initial presentation showing a right temporal-parietal intracerebral hemorrhage with intraventricular extension.
Figure 2
Figure 2
The 7-month follow-up MR study documents healing of the hemorrhagic site, with a residual slit-like cavity without mass effect (A, B). MR angiography (C) did not reveal the arteriovenous malformation.
Figure 2
Figure 2
The 7-month follow-up MR study documents healing of the hemorrhagic site, with a residual slit-like cavity without mass effect (A, B). MR angiography (C) did not reveal the arteriovenous malformation.
Figure 2
Figure 2
The 7-month follow-up MR study documents healing of the hemorrhagic site, with a residual slit-like cavity without mass effect (A, B). MR angiography (C) did not reveal the arteriovenous malformation.
Figure 3
Figure 3
Digital subtraction angiography (DSA) obtained after the second hemorrhage reveals an arteriovenous malformation nidus in the right temporal-parietal region, supplied by the posterior division of the right middle cerebral artery (A). The venous drainage is superficial via a cortical vein (the lesser anastomotic vein of Trolard) (B).
Figure 3
Figure 3
Digital subtraction angiography (DSA) obtained after the second hemorrhage reveals an arteriovenous malformation nidus in the right temporal-parietal region, supplied by the posterior division of the right middle cerebral artery (A). The venous drainage is superficial via a cortical vein (the lesser anastomotic vein of Trolard) (B).
See this image and copyright information in PMC

Comment in

References

    1. Al-Jarallah A, Al-Rifai MT, Riela AR, Roach ES. Nontraumatic brain hemorrhage in children: Etiology and presentation. J Child Neurol. 2000;15:284–289. - PubMed
    1. Broderick JP, Adams HP, Jr, Barsan W, Feinberg W, Feldmann E, Grotta J, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: A statement for healthcare professionals from a special writing group of the stroke council, american heart association. Stroke. 1999;30:905–915. - PubMed
    1. Broderick J, Talbot GT, Prenger E, Leach A, Brott T. Stroke in children within a major metropolitan area: The surprising importance of intracerebral hemorrhage. J Child Neurol. 1993;8:250–255. - PubMed
    1. Burger IM, Murphy KJ, Jordan LC, Tamargo RJ, Gailloud P. Safety of cerebral digital subtraction angiography (DSA) in children. complication rate analysis in 241 consecutive diagnostic angiograms. Stroke. 2006;37:2535–2539. - PubMed
    1. Chappell ET, Moure FC, Good MC. Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurysms: A meta-analysis. Neurosurgery. 2003;52:624–631. - PubMed

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