Abstract
Arteriovenous malformations of the choroid plexus are uncommon causes of intraventricular hemorrhage. Only 27 cases have been reported recently of this hemorrhagic form AVM. The authors experienced two cases of AVM of the choroid plexus and each of them were successfully removed by transventricular approach. We describe these two cases and present some characteristics of this disease, with a review of the literature.
Both cases were adult male patients who experienced sudden onset of headache, vomiting and decrease of their consciousness. CT scan showed massive intraventricular hemorrhage predominantly on lateral ventricules without intracerebral hematoma. Angiography revealed AVM located on the choroid plexus which were fed by the branch of the anterior or posterior choroidal arteries and drained into the great vein of Galen and the vein of Resenthal. Each of them was totally removed by transventricular approach. Pathohistological findings showed typical forms of AVM located on the choroid plexus.
As a cause of intraventricular hemorrhage in adults, the AVM of the choroid plexus is significant. Of all the cerebral AVMs, so called deep-seated AVMs are the most difficult to remove. But AVM of the choroid plexus are located on the plexus so surgical extripation is easier. It is very difficult to clarify AVM of the choroid plexus and other deep-seated AVMs preoperatively. However the following findings will support the diagnosis of the AVMs of the choroid plexus; 1: CT scan shows pure intraventricular hemorrhage without brain parencymal destruction. 2 : The blood supply is regulated of the branch of choroid arteries.
