Isquemia cerebral tardía tras la rotura de malformación arteriovenosa: Reporte de caso

Johann Bill Pinedo Avila; Mayra Leonor  Rivera-Paico; Hugo Justo  Peralta- Olortegui

doi:10.56838/icmed.v14i3.221

Authors

Johann Bill Pinedo-Ávila Hospital Nacional Guillermo Almenara Irigoyen, Lima - Perú. https://orcid.org/0000-0002-4195-5335
Mayra Leonor Rivera-Paico Hospoital Regional Docente de Cajamarca, Cajamarca - Perú. https://orcid.org/0009-0007-0454-7870
Hugo Justo Peralta- Olortegui Hospital de Emergencias de Villa El Salvador, Lima -Perú https://orcid.org/0009-0006-0404-9057

DOI:

https://doi.org/10.56838/icmed.v14i3.221

Keywords:

cerebral arteriovenous malformation, intracranial vasospasm, intracranial subarachnoid hemorrhage, intracerebral hemorrhage, cerebral intraventricular hemorrhage, therapeutic embolization

Abstract

Cerebral vasospasm (CV) is a potentially fatal complication that may arise following subarachnoid hemorrhage (SAH),
leading to the constriction of cerebral arteries and subsequent delayed cerebral ischemia (DCI). Although CV is most
commonly associated with aneurysmal SAH, it has also been reported in patients with arteriovenous malformations (AVMs). In this report, we present the case of a 13-year-old patient with a history of ruptured left occipital AVM who developed DCI after AVM rupture during embolization. The patient was managed in the neurosurgery intensive care unit and received external ventricular drains (EVD), osmotherapy with mannitol, vasopressors, and corticosteroids. While
the patient exhibited initial signs of improvement, neurological deterioration occurred two weeks later despite the
appearance of new discrete hypodensities. However, the patient ultimately made a satisfactory recovery. Our findings
underscore the importance of close monitoring and timely intervention in patients with AVM-related CV to improve
clinical outcomes.