Two cases of elderly patients with ruptured AVM with contrast medium extravasation during cerebral angiography

Two cases are reported of elderly patients who experienced intracranial extravasation of contrast medium (CM) during carotid angiography (CAG) for ruptured cerebral arteriovenous malformations (AVM). The first patient, an 87-year-old male with no history of hypertension, was admitted immediately fol...

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Bibliographic Details
Published inNō shinkei geka Vol. 29; no. 12; p. 1195
Main Authors Ueda, Y, Urakawa, M, Kawakami, N
Format Journal Article
LanguageJapanese
Published Japan 01.12.2001
Subjects
Aged
Aged, 80 and over
Cerebral Angiography - adverse effects
Extravasation of Diagnostic and Therapeutic Materials - etiology
Female
Humans
Intracranial Arteriovenous Malformations - complications
Intracranial Arteriovenous Malformations - diagnostic imaging
Male
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Summary:Two cases are reported of elderly patients who experienced intracranial extravasation of contrast medium (CM) during carotid angiography (CAG) for ruptured cerebral arteriovenous malformations (AVM). The first patient, an 87-year-old male with no history of hypertension, was admitted immediately following a loss of consciousness after swimming in a pool. CT scan revealed a large intracranial hematoma in the left frontal lobe. CAG performed 1 hour after his arrival revealed a small AVM, fed by the left anterior cerebral artery with concomitant extravasation of CM. The patient's condition subsequently deteriorated and he died the following day. The second patient, a 71-year-old female, was admitted to our hospital in a comatose state after complaining of a severe headache. CT scan revealed a right parietal lobe hemorrhage extending into the ventricles. CAG was performed and demonstrated a small AVM in the right parietal lobe with extravasation of CM. Following emergency removal of the hematoma and AVM, the patient regained consciousness although some motor deficits persisted. A literature review revealed that only 6 cases of CM extravasation with ruptured AVM have been previously reported. The 4 previous cases involved patients 9, 15, 33 and 66-year-old, the younger three of which had a good outcome. The patients reported here were much older, and had a much less favorable outcome. Thus, AVM with CM extravasation may have a better prognosis in younger individuals.
ISSN:0301-2603