Cerebral arteriovenous malformations (AVMs) represent congenital anomalies of blood vessels composed of a nidus of anomalous arterial and venous vessels without a capillary network. We describe a case of bleeding cerebral AVM in a pregnant women at the second quarter of gestation and diagnosed by digital subtraction angiography showing a large principal arterial nidus supply. The AVM was treated by endovascular embolization at the 27th week of gestation. The post-operative course was uneventful and a caesarean section was performed at the 37th week of gestation. The endovascular approach may represent a safe method in the treatment of this cerebral condition during pregnancy.
CognardCSpelleLPierotL. Pial arteriovenous malformation. In: ForstingMWankeI, eds. Intracranial Vascular Malformations and Aneurysms. From diagnostic work-up to endovascular therapy. Berlin Heidelberg: Springer-Verlag; 2005. p. 51–112.
2.
BerensteinALasjauniasPTer BruggeKG. Cerebral vascular malformations: Incidence, classification, angioarchitecture, and symptomatology of brain arteriovenous and venous malformation. In: Surgical Neuroangiography. Berlin Heidelberg: Springer-Verlag; 2004. 609–691.
3.
MeyersPMHalbachVVMalekAM. Endovascular treatment of cerebral artery aneurysm during pregnancy: Report of three cases. Am J Neuradiol.2000; 21: 1306–1311.
4.
PiotinMDe Souza FilhoCBKothimbakamR. Endovascular treatment of acutely ruptured intracranial aneurysms in pregnancy. Am J Obstet Gynecol.2001; 185: 1261–1262.
5.
PiotinMMounayerCSpelleL. Malformations artérioveineuses intracérébrales et grossesse: Quelle prise en charge?J Neuroradiol.2004; 31: 376–378.
6.
DiasMSSekharLN. Intracranial hemorrhage from aneurysms and arteriovenous malformations during pregnancy and the puerperium. Neurosurgery. 1990; 27: 855–865.
7.
FinnertyJJChisholmCAChappleH. Cerebral arteriovenous malformation in pregnancy: Presentation and neurologic, obstetric, and ethical significance. Am J Obstet Gynecol.1999; 181: 296–303.
8.
HortonJCChambersWALyonsSL. Pregnancy and the risk of hemorrhage from cerebral arteriovenous malformations. Neurosurgery. 1990; 27: 867–71.
9.
SharmaSKHerreraERSidawiJE. The pregnant patient with an intracranial arteriovenous malformation; caesarean or vaginal delivery using regional or general anesthesia?Reg Anesth.1995; 20: 455–458.
10.
EnglishLAMulveyDC. Ruptured arteriovenous malformation and subarachnoid hemorrhage during emergent caesarean delivery: A case report. AANA J.2004; 72: 423–426.
11.
RobinsonJLHallCSSedzimirCB. Arteriovenous malformations, aneurysms and pregnancy. J Neurosurg.1974; 41: 63–70.
12.
GorsonROLassenMRosensteinM. Patient dosimetry in diagnostic radiology. Handbook of Medical Physics. Boca Raton, FL: CRC Press; 1984; 467–526
13.
OgilvyCSStiegEPAwadI. Recommendations for the management of intracranial arteriovenous malformations. Stroke.2001; 132: 1458–1471.
