Ruptured Cerebral Arteriovenous Malformation During Fifth Pregnancy: Case Report and Literature Review

Yuhei Michiwaki, Akira Nakamizo, Yosuke Kawano, Tomoyuki Tsumoto

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: Whether the risk of rupture of a cerebral arteriovenous malformation (AVM) increases during pregnancy remains controversial. Moreover, it is unclear whether the number of pregnancies correlates with AVM rupture risk. We report a case of ruptured AVM during the fifth pregnancy. Case Description: A 34-year-old woman presenting sudden headache and vomiting was admitted to our hospital. Neuroimaging revealed a subarachnoid hemorrhage due to a ruptured AVM in the right temporal lobe. She was pregnant (9 weeks and 1 day), and she had previously experienced 4 normal vaginal deliveries (gravidity and parity G 4 P 4 ) without complications. Elective treatment including neuroendovascular and direct surgery was performed, and the AVM was safely resected (at 15 weeks, 6 days of pregnancy). She underwent elective caesarean section without complications 151 days after the AVM resection (at 37 weeks, 1 day of pregnancy), and the baby was healthy. Conclusions: This report suggests that the risk of AVM rupture persists even after multiple deliveries. Intracranial hemorrhage should be suspected in pregnant patients who underwent multiple deliveries, and a rapid diagnosis and appropriate treatment are necessary.

Original languageEnglish
Pages (from-to)45-47
Number of pages3
JournalWorld Neurosurgery
Publication statusPublished - Apr 2019
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology


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