Ruptured occult arteriovenous malformation associated with an unruptured intracranial aneurysm: report of three cases

Neurosurgery. 1992 Apr;30(4):603-6; discussion 606-7. doi: 10.1227/00006123-199204000-00023.


Three patients who were admitted for intracranial hemorrhage are reported. Cerebral angiography demonstrated an aneurysm arising from the middle cerebral artery bifurcation. No other malformation was visible either on the computed tomographic scan or on angiography. The diagnosis was ruptured middle cerebral artery aneurysm with intracerebral hematoma. At surgery, there was no blood in the sylvian fissure and the aneurysm was not ruptured. Evacuation of the hematoma and thorough exploration of the cavity led to the discovery and resection of a small vascular anomaly typical of an arteriovenous malformation responsible for the hemorrhage. Occult vascular malformations and the association of aneurysm with arteriovenous malformations are discussed. In these 3 patients, the coexistence of these two malformations could be related to a common congenital abnormality.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Arteriovenous Fistula / complications
  • Arteriovenous Fistula / congenital*
  • Arteriovenous Fistula / diagnostic imaging
  • Arteriovenous Fistula / surgery
  • Cerebral Angiography
  • Cerebral Hemorrhage
  • Female
  • Humans
  • Intracranial Aneurysm / complications*
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / surgery
  • Intracranial Arteriovenous Malformations / complications*
  • Intracranial Arteriovenous Malformations / diagnostic imaging
  • Intracranial Arteriovenous Malformations / surgery
  • Male
  • Middle Aged
  • Retrospective Studies
  • Rupture, Spontaneous