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Research ArticleNeurointerventionE
Open Access

Endovascular Treatment of Ruptured Brain AVMs in the Acute Phase of Hemorrhage

W.J. van Rooij, S. Jacobs, M. Sluzewski, G.N. Beute and B. van der Pol
American Journal of Neuroradiology June 2012, 33 (6) 1162-1166; DOI: https://doi.org/10.3174/ajnr.A2995
W.J. van Rooij
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S. Jacobs
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M. Sluzewski
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G.N. Beute
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B. van der Pol
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    Fig 1.

    71-year-old man with sudden headache and hemianopsia. A, CT scan shows posterior temporal hematoma with an outlined venous aneurysm indicating the source of the hemorrhage (arrow). B, Lateral view of vertebral angiography shows micro-AVM with intranidal aneurysm as the source of hemorrhage (arrow). C, Nonsubtracted lateral view shows Onyx cast after embolization. The intranidal aneurysm is partly filled with Onyx (arrow). D, Complete obliteration of the AVM with Onyx.

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    Fig 2.

    6-year-old girl with sudden headache and left-sided weakness. A, T2-weighted MR imaging demonstrates intraparenchymal hematoma and flow voids indicating vascular malformation. B, Frontal view of right internal carotid angiography shows single-hole, high-flow pial fistula with dilated draining veins. C, Fluoroscopic frontal image during embolization. The fistula is occluded with Onyx (short arrow) during balloon occlusion of the feeding artery (long arrow) to block the flow and prevent migration of Onyx to the venous side of the fistula. D, Complete obliteration of the pial fistula.

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    Fig 3.

    23-year-old man with sudden headache and hemianopsia. A, T1-weighted MR imaging demonstrates left occipital hematoma. B, Frontal view of concomitant left internal carotid and vertebral angiogram shows small occipital AVM with a single draining vein (arrow). C, Nonsubtracted image of Onyx cast after embolization: complete filling of the nidus and proximal part of the draining vein (arrow). D, Angiography demonstrating complete obliteration of the AVM.

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    Fig 4.

    49-year-old man with sudden headache and dysphasia and frontal hematoma on CT scan. A, Frontal view of left internal carotid angiogram shows small left frontal AVM with intranidal aneurysm as the source of hemorrhage (arrow). B, Fluoroscopic image during embolization with the tip of the microcatheter inside the aneurysm (arrow). C, Nonsubtracted image with Onyx cast filling the intranidal aneurysm completely. D, Small remnant of the AVM after embolization without filling of the aneurysm. The remnant was subsequently treated with gamma knife radiosurgery.

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American Journal of Neuroradiology: 33 (6)
American Journal of Neuroradiology
Vol. 33, Issue 6
1 Jun 2012
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Cite this article
W.J. van Rooij, S. Jacobs, M. Sluzewski, G.N. Beute, B. van der Pol
Endovascular Treatment of Ruptured Brain AVMs in the Acute Phase of Hemorrhage
American Journal of Neuroradiology Jun 2012, 33 (6) 1162-1166; DOI: 10.3174/ajnr.A2995

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Endovascular Treatment of Ruptured Brain AVMs in the Acute Phase of Hemorrhage
W.J. van Rooij, S. Jacobs, M. Sluzewski, G.N. Beute, B. van der Pol
American Journal of Neuroradiology Jun 2012, 33 (6) 1162-1166; DOI: 10.3174/ajnr.A2995
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