The most frequent and devastating complication of the endovascular treatment of cerebral AVMs is hemorrhage. This report describes three patients with cerebral AVM who encountered bleeding during Onyx-18 embolization. The bleeding was discovered promptly during the procedure and hemorrhage quickly prevented using Onyx-18. All three patients recovered without any new neurological symptoms. Early detection and prevention of bleeding are very important during interventional procedures to avoid craniotomy and improve the prognosis of patients.
GobinYPLaurentAMerienneL. Treatment of brain arteriovenous malformations by embolization and radiosurgery. J Neurosurg85:19–28, 1996.
2.
GruberAUngersböckKReinprechtA. Evaluation of cerebral vasospasm after early surgical and endovascular treatment of ruptured intracranial aneurysms. Neurosurgery42: 258–268, 1998.
3.
HenkesHNahserHCBerg-DammerE. Endovascular therapy of brain AVMs prior to radiosurgery. Neurol Res.1998; 20: 479–492.
4.
SpetzlerRFMartinNACarterLP. Surgical management of large AVM's by staged embolization and operative excision. J Neurosurg. 1987; 67: 17–28.
5.
BeamerYBCorsinoJFLyndeRG. Rupture of aneurysm of the internal carotid artery during arteriography with filling of subarachnoid space and demonstration of a temporal lobe mass: Case report. J Neurosurg. 1969; 31: 224–226.
6.
GerlockAJ. Rupture of posterior inferior cerebellar artery aneurysm into the subarachnoid space during angiography. Case report. J Neurosurg. 1975; 42: 469–472.
7.
FeildJRRobertsonJTDesaussureRL. Complications of cerebral angiography in 2000 consecutive cases. J Neurosurg. 1962; 19: 775–781.
8.
FaulhauerKMüklerE. [Extravasation of contrast medium from a carotid aneurysm in the ventricular system (author's transl)]. Nervenarzt. 1977; 48: 621–625.
9.
Arteriovenous Malformation Study Group. Arteriovenous malformations of the brain in adults. N Engl J Med.1999; 340: 1812–1818.
10.
PaulsenRDSteinbergGKNorbashAM. Embolization of basal ganglia and thalamic arteriovenous malformations. Neurosurgery. 1999; 44: 991–996; discussion 996–997.
11.
VinuelaFDionJEDuckwilerG. Combined endovascular embolization and surgery in the management of cerebral arteriovenous malformations: experience with 101 cases. J Neurosurg. 1991; 75: 856–864.
12.
BiondiALe JeanLCapelleL. Fatal hemorrhagic complication following endovascular treatment of a cerebral arteriovenous malformation. Case report and review of the literature. J Neuroradiol. 2006; 33(2): 96–104.
13.
JafarJJDavisAJBerensteinA. The effect of embolization with N-butyl cyanoacrylate prior to surgical resection of cerebral arteriovenous malformations. J Neurosurg. 1993; 78: 60–69.
14.
PicardLDa CostaEAnxionnatR. Acute spontaneous hemorrhage after embolization of brain arteriovenous malformation with N-butyl cyanoacrylate. J Neuroradiol. 2001; 28(3): 147–165.
15.
LedezmaCJHohBLCarterBS. Complications of cerebral arteriovenous malformation embolization: multivariate analysis of predictive factors. Neurosurgery. 2006; 58(4): 602–611; discussion 602–611.
16.
TaylorCLDuttonKRappardG. Complications of preoperative embolization of cerebral arteriovenous malformations. J Neurosurg. 2004; 100(5): 810–812.
17.
HenkesHGotwaldTFBrewS. Pressure measurements in arterial feeders of brain arteriovenous malformations before and after endovascular embolization. Neuroradiology. 2004; 46: 673–677.
18.
van RooijWJSluzewskiMBeuteGN. Brain AVM Embolization with Onyx. Am J Neuroradiol. 2007; 28: 172–177.
19.
IwamaTYoshimuraKKellerE. Emergency craniotomy for intraparenchymal massive hematoma after embolization of supratentorial arteriovenous malformations. Neurosurgery. 2003; 53: 1251–1258; discussion 1258–1260.
