Treatment of arteriovenous malformations associated with ruptured intracranial aneurysm

Spontaneous subarachnoid hemorrhage (SAH) is a specific characteristic of aneurysmal rupture. SAH coexisting with arteriovenous malformations is challenging to treat because the patient status at admission is severe and the therapeutic approach is multidisciplinary: endovascular treatment, cerebral fluid drainage, and decompressive craniectomy. We report a clinical case successfully treated for cerebellar hemorrhage due to a ruptured aneurysm with arteriovenous malformations. A 65-year-old woman was admitted to Can Tho SIS General Hospital within six hours of stroke onset. She experienced loss of consciousness, aphasia, and high blood pressure. Non-contrast computed tomography showed a diffused SAH in both cerebellum hemispheres, Sylvian fissure, intraventric-ular hemorrhage, and non-communicating hydrocephalus. Her medical history included uncon-trolled hypertension. The patient underwent multidisciplinary treatment for hydrocephalus, cere-bellar edema, and embolization to control recurrent ruptured arteriovenous malformations. She recovered well and was discharged on day 30 with a Modified Rankin Scale score of 1.