Haemorrhagic complication after total extirpation of huge arteriovenous malformations

Two cases with huge arteriovenous malformations (AVMs) who developed haemor rhagic complications after surgery are described. The cause of the postoper ative haemorrhage was considered to be the normal perfusion pressure breakt hrough phenomenon and/or occlusive hyperaemia. These two haemodynamic insul ts possibly occur simultaneously and induce life-threatening haemorrhage. I t was concluded that a huge high-flow AVM with a large venous ampulla in it s deep drainers has a high risk of a postoperative intravenous thrombosis, resulting in haemorrhage together with normal perfusion pressure breakthrou gh phenomenon. (C) 2000 Harcourt Publishers Ltd.