高血圧性脳内出血に類似した破裂脳動静脈奇形5症例の報告  [in Japanese] Ruptured Small AVMs Mimicking Hypertensive Intracerebral Hemorrhage : Report of 5 Cases  [in Japanese]

Hypertensive intracerebral hemorrhage (HT-ICH) is the most common pathological condition in all intracranial hemorrhages. We report 5 cases of ICH caused by rupture of a small intra-cerebral AVM, which were all treated surgically. The plain CT scans all demonstrated ICHs looking like hypertensive type, and some 3D-CT scans could not reveal any vascular malformation. In 42 cases of all surgically treated ICH in 2 consecutive years in our institution, 5 cases were pathologically diagnosed as ruptured AVM. The average age of the 5 patients was 74. The patients comprised 4 males and 1 female. Bleeding points were putamen in 4 cases and subcortex in 1. Hemorrhages looking like HT-ICH caused by AVM are not rare even in elderly patients. At the time of ICH surgery, caution is needed in case of endoscopic surgery or burr hole surgery, taking vascular malformation into consideration.