DURAL ARTERIOVENOUS MALFORMATION CAUSING BRAIN-STEM HEMORRHAGE

A 40 year old man developed a brainstem haemorrhage from an arterioven ous malformation of the tentorial incisura. Although the location of t he haemorrhage represents a unique report, this case illustrates 3 imp ortant points that can be generally applied to dural arteriovenous mal formations. Firstly, the dangers of dural arteriovenous malformations with cortical venous drainage. Secondly, with regards their risk of ha emorrhage, dural arteriovenous malformations (tentorial arteriovenous malformations in particular) cannot be dismissed as benign until angio graphy has been performed. Finally, angiography performed for the purp ose of investigating the possibility of an arteriovenous malformation being responsible for an intraparenchymal haemorrhage cannot be consid ered truly negative unless the external carotid circulation has failed to demonstrate an arteriovenous malformation in addition to the inter nal carotid and vertebral circulations. (C) Pearson Professional 1995