E115

CEREBRELLUM AND BRAIN STEM - Arteriovenous malformation and haemorrhage

Description
In the left cerebellopontine angle tortuous vessels of varying size can be seen; these are closely applied to the left cerebellar hemisphere and extended across to the inferior border of the pons; before dissection they were also applied to the lateral surface of the medulla. Bleeding from the lesion had occurred through the inferior cerebellar peduncle and blood clot can be seen in the fourth ventricle. There was a dural attachment apparent to the lateral border of the tentorium.
History
This man presented at the of 46 with a subarachnoid haemorrhage; an arteriovenous malformation was identified and treated by radiotherapy. In 1978 a left external carotid artery ligation was performed. He presented finally at the age of 50 with a headache of acute onset, left-sided weakness, vomiting, restlessness and gradual loss of consciousness to coma. Death occurred some 24 hours after the onset of symptoms.