J Neuroradiology
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Review Case Reports
Fatal hemorrhagic complication following endovascular treatment of a cerebral arteriovenous malformation. Case report and review of the literature.
Evaluation of the natural history of brain Arteriovenous Malformations (AVMs) including its morbidity and mortality is a crucial point in the management of patients having a cerebral AVM. The risks associated with the AVM natural history, especially regarding the occurrence of an hemorrhage, have to be compared to the risks due to the therapeutic approach. In the literature, the risk of annual bleeding of an AVM is estimated from 2 to 4%. ⋯ This case contributes to remind that embolization, even in specialized centers with experience in the management of this pathology, can be followed by a poor and even fatal outcome. In most cases, the treatment is performed in order to protect the patient of a potential risk. Consequently, the complication of the embolization must always be carefully considered and discussed between the medical team, the patient and its family for planning the AVM endovascular treatment.
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The aim of this study was to assess the role of spiral CT for the diagnosis of brain death. ⋯ The absence of internal cerebral vein opacification and the absence of bilateral enhancement of cortical MCA branches constituted the best criteria of brain death by contrast enhanced spiral CT.