Reexamination by 4-vessel Angiography Reveals Spinal Arteriovenous Malformation Presenting with Subarachnoid Hemorrhage

Abstract

The authors report a case of subarachnoid hemorrhage (SAH) due to rupture of a spinal arteriovenous malformation (AVM) at the level of C3. The case was a 69-year-old man complaining of severe headache with nuchal pain. CT scan showed a diffuse dominant SAH at the posterior fossa. Conventional MRI and cerebral 4-vessel angiography failed to disclose the site of bleeding. The same study was repeated two weeks later, and revealed a spinal AVM (glomus type) at the level of C3, and was followed by successful resection. SAH of unknown origin requires reexamination by cerebral 4-vessel angiography in cases of suggested spinal AVM.