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The patient a young gentleman was brought to the ICU with history of
sudden los of consciousness. The patient then after
neuroradiologic work-up showed a space-occupying lesion in the
posterior fossa with signs of hemorrhage. Despite massive
dehydration therapy he continued to deteriorate after relative
improvement with nuchal rigidity and signs of impaction.
The patient was brought to the operating room and in the setting
position, a mid-line occipital osteoplastic craniotomy with
reflection of the flap to the inferior corner of the wound. The dura
was opened and the the heamatoma was inspected and a tonsilar AVM
with feeders from the right PICA was resected with the compressing
heamatoma removed.
After removal of the heamatoma and coagulation and bisection of
the the AVM, inspection of other parts of the surrounding neural
structures was negative. |
