Keisuke Onoda*, Akira Saitoh, Shuhei Yamasaki, Ryohei Sashida, Tomihiro Wakamiya, Masahiro Indou, Kimihiro Nakahara, Tatsuya Tanaka, Takashi Agari, Takashi Sugawara, Kazuaki Shimoji, Eiichi Suehiro, Hiroshi Itokawa and Akira Matsuno

Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, Japan

*Corresponding Author: Keisuke Onoda, Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita Hospital, Chiba, Japan.

Received: August 21, 2025; Published: September 19, 2025

Abstract

Background: Choroidal arteriovenous malformations (AVMs) are exceedingly rare vascular lesions that often present with hemorrhage owing to their deep-seated location and complex angioarchitecture.

Case Description: A 70-year-old woman presented with an unknown-onset headache and impaired consciousness. Computed tomography revealed massive intraventricular hemorrhage with acute hydrocephalus. Digital subtraction angiography revealed a choroidal AVM in the right trigonal region, fed by the anterior choroidal arteries. An external ventricular drain was placed immediately. Two weeks after neurological improvement, microsurgical resection was performed using a high occipital transcortical approach. Complete resection of the AVM nidus was achieved while preserving the surrounding structures. Postoperative MRI and MRA confirmed complete obliteration. The patient recovered without any neurological deficits, and at 3-month follow-up remained neurologically intact without evidence of rebleeding.

Conclusion: Although rare, choroidal AVMs can present as intraventricular hemorrhages in elderly patients. This case highlights the feasibility of a high occipital transcortical approach for deep-seated choroidal AVMs and emphasizes the importance of meticulous surgical planning to achieve complete and safe resection.

Keywords: Choroidal Arteriovenous; Malformation Presenting; Intraventricular Hemorrhage; Transcortical

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Citation

Citation: Keisuke Onoda.,et al. “A Case of Choroidal Arteriovenous Malformation Presenting with Intraventricular Hemorrhage: Successful Resection via High Occipital Transcortical Approach".Acta Scientific Neurology 8.10 (2025): 21-24.

Copyright

Copyright: © 2025 Keisuke Onoda.,et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.