====== Vasospasm Due to Arteriovenous Malformation-Associated Hemorrhage ======

Although it is well characterized in [[aneurysmal subarachnoid hemorrhage]], [[vasospasm]] is exceedingly rare in [[ruptured intracranial arteriovenous malformation]]. Subsequently, this complication is poorly characterized with regard to delayed cerebral ischemia (DCI). 

[[Cerebral vasospasm]] (CVS) after a [[Ruptured Intracranial Arteriovenous Malformation]] is rarely reported. 

A total of 160 patients with ruptured [[Intracranial Arteriovenous Malformation]] were admitted to the Department of Neurosurgery [[University Hospital Frankfurt]], from 2002 to 2018. The frequency of cerebral vasospasm after AVM hemorrhage and the impact of AVM-associated aneurysms were evaluated. They compared different bleeding patterns, such as [[intracerebral hemorrhage]] (ICH), [[subarachnoid hemorrhage]] (SAH) or a combination of both (ICH + SAH) and evaluated predictive variables for outcome in last follow-up.

A total of 62 (39%) patients had AAA, mostly located prenidal (75.8%). AVMs with ruptured aneurysms often resulted in ICH with SAH component (p < 0.001). Eighty-two patients (51%) presented a SAH component, and CVS occurred in 6 patients (7.3%), mostly due to a ruptured infratentorial AVM (p < 0.03). Infratentorial location and the amount of SAH component (p < 0.001) predicted the incidence of CVS significantly. Cerebral infarction was significantly associated with CVS (p < 0.02).

SAH component and infratentorial location of ruptured AVMs may harbor a higher risk for CVS. Follow-up with angiographic imaging should be considered in patients with infratentorial AVM hemorrhage and delayed neurologic deterioration to rule out CVS
((Dinc N, Won SY, Eibach M, Quick-Weller J, Konczalla J, Berkefeld J, Seifert V,
Marquardt G. Cerebral Vasospasm Due to Arteriovenous Malformation-Associated
Hemorrhage: Impact of Bleeding Source and Pattern. Cerebrovasc Dis. 2019 May
8:1-6. doi: 10.1159/000500596. [Epub ahead of print] PubMed PMID: 31067536.
)).