They comprise less than 15% of all Intracranial Arteriovenous Malformations 2). and this relatively low incidence has led authors to combine them with brainstem arteriovenous malformation in reports on infratentorial or posterior fossa AVMs 3) 4) 5) 6) 7) 8) 9) 10) 11) 12)
Emergency microsurgery is effective in the treatment of ruptured cerebellar AVM 14).
Occipital transtentorial approach is a valuable approach for specific superior vermian, superomedian cerebellar, and tectal AVMs. Detailed assessment of angiographic features may however preclude its safety as a unique treatment plan, and complementary or alternative therapeutic options should be considered 15) 16).
Radiosurgery is an effective treatment modality for Cerebellar Arteriovenous Malformation with relatively limited adverse events. Infratentorial location did not affect radiosurgery outcomes 17). Proved to be most effective for patients with smaller and previously nonembolized cerebellar malformations. Hemorrhage during the latency period occurred at a rate of 2.0% per year until obliteration occurred 18).
Due to the relatively small volume of the posterior fossa and their proximity to the brainstem, rupture of cerebellar AVMs may quickly result in devastating neurological consequences.
Arteriovenous malformation (AVM)-related aneurysms supported by numerous reports is that these aneurysms should regress if the AVM is excluded from the circulation.
A case of 46-year-old man who presented with a posterior fossa AVM with an aneurysm on the posterior inferior cerebellar artery feeding the AVM. The nidus of the AVM was successfully excluded by glue embolization, with initial regression of the PICA aneurysm on serial imaging. Five years after the endovascular treatment, the aneurysm showed significant re-growth necessitating endovascular coiling. This case presents the re-growth of an AVM-related aneurysm and emphasizes the importance of long-term follow-up of such aneurysms even if the AVM is completely excluded 19).
Resolution of hemifacial spasm after successful treatment of posterior fossa arteriovenous malformation by gamma knife radiosurgery 20).
A 25-year-old woman was admitted because of frequent vomiting and headache which had lasted over one week. She had initially clear consciousness but slowly progressive mild headache and dysphoria. Emergency cranial CT revealed a 4 cm haematoma in the left cerebellar hemisphere. CT angiography showed a 2×2 cm nidus of an arteriovenous malformation (AVM) in the left hemisphere fed from the left posterior inferior cerebellar artery and draining into the inferior hemispheric vein. We performed a surgical resection of the AVM after decompression therapy to counteract the brain oedema. She recovered completely without any neurological deficits. This case recalls the importance of cooperation between diagnostic neuroradiology and neurosurgery in emergency, considering AVM, even if infrequent, among possible diseases 21).