J Korean Neurosurg Soc.  2003 Jul;34(1):54-56.

Surgical Extirpation of Large Arteriovenous Malformation Treated with Hunterian Carotid Ligation 37 Years Ago: Case Report

• Kim JM
• Cheong JH
• Bak KH
• Kim CH

Abstract

A 63-year-old man presented with severe headache and left side motor weakness after transient loss of consciousness is reported. His right internal carotid artery(ICA) was ligated without distal bypass 37 years ago due to arteriovenous malformation(AVM) rupture. Preoperative cerebral angiography demonstrated short right ICA proximal stump as a result of previous carotid ligation and large AVM nidus with feeders of right middle cerebral artery(MCA), which was fed from the left ICA, and right posterior cerebral artery. Complete obliteration of malformed vessels was performed via the right transsylvian transcortical approach. Postoperative cerebral angiography demonstrated complete removal of the AVM with preservation of normal vasculature. The postoperative course was uneventful. Considering multiple patch calcification of AVM nidus, the AVM may be recanalized and grew gradually for a long time after Hunterian ligation.

Keyword

Carotid ligation; Recanalization; Arteriovenous malformation

MeSH Terms

Arteriovenous Malformations*
Cerebral Angiography
Headache
Humans
Ligation*
Middle Aged
Posterior Cerebral Artery
Rupture
Unconsciousness