INTRACEREBRAL HEMORRHAGE REMOTE FROM A RADIOSURGICALLY OBLITERATED ARTERIOVENOUS MALFORMATION

Follow-up angiography that no longer shows a cerebral arteriovenous ma lformation (AVM) after radiosurgery is thought to indicate obliteratio n and protection from risk of hemorrhage. However, angiographically oc cult vascular malformations can bleed, so one might question the degre e of protection provided by radiosurgery. The patient reported here wa s anticoagulated for deep vein thrombosis after a cerebellar AVM had b een ''obliterated'' by treatment with a gamma knife. He subsequently s uffered a fatal supratentorial hemorrhage. At autopsy, no bleeding was seen in the region of the thrombosed AVM. This case is presented as f urther evidence of the efficacy of radiosurgery in the treatment of ce rebral AVMs.