RECURRENCE OF A CEREBRAL ARTERIOVENOUS MALFORMATION AFTER SURGICAL EXCISION

Complete excision of a cerebral arteriovenous malformation (AVM) shoul d eliminate the future risk of an associated intracranial hemorrhage. Because total removal of an AVM may be difficult to assess at the rime of surgery, postoperative angiography has become the accepted standar d for documenting that the removal has been accomplished. However, eve n angiographically confirmed excision of an AVM does not completely en sure against rebleeding. Regrowth of an AVM with subsequent hemorrhage can occur. This has been documented in children and is attributed to forces acting on the immature vasculature of these younger patients. T he authors report the case of an older patient whose AVM recurred when he was 28 years of age, despite an angiographically proven complete e xcision. and emphasize that, even in adults, angiographic documentatio n of total removal does not always eliminate the risk of reformation o f an AVM.