Arteriovenous malformations (AVMs) located in the infratentorial compartment make up less than 15% of brain AVMs in large series [1-3]. Despite their relative paucity in number, infratentorial AVMs represent an important subset for treatment because as many as 85% of patients with these lesions present with hemorrhage [1,4-7], with a propensity toward poor outcome after rupture compared with their supratentorial counterparts . Hemorrhage as a presenting symptom of infratentorial AVMs may in part be explained by a relatively high incidence of prenidal aneurysms [7-9] and deep venous drainage [7,10]. Consequently, a newly diagnosed infratentorial AVM should be strongly considered for treatment given the unclear natural history and tendency toward poor outcome after rupture. Presentation and natural history Mass effect from an infratentorial AVM is most frequently associated with a cerebellopontine angle or brainstem location, typically with a cranial neuropathy [1,11–14]. Presentation with hydrocephalus has been described [15,16]. Neuralgia is an uncommon presentation and has resolved after AVM treatment [17–19]. Seizure is relatively absent as a presenting symptom in infratentorial AVMs, compared with AVMs of the supratentorial compartment [8,10,11]; consequently, unruptured AVMs are more likely to be clinically silent.
|Original language||English (US)|
|Title of host publication||Comprehensive Management of Arteriovenous Malformations of the Brain and Spine|
|Publisher||Cambridge University Press|
|Number of pages||15|
|State||Published - Jan 1 2015|
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