A-34-year-old male, suffering from a sudden onset of severe headache and being unconscious, was admitted in our hospital Jan. 9. 1983. CT and CAG showed intraventricular hematoma and a large arteriovenous malformation involving the length of the corpus callosum in the midline.There were two nidi at the genu corporis callosi and one at the splenium; and the origin of bleeding seemed to be the most anterior nidus. We planned two staged operations for this vascular malformation.
After regaining consciousness, the patient underwent a bifrontal craniotomy followed by extirpation of both nidi at the genu corporis callosi. He made an uneventful postoperative recovery.
The second operation was performed four months later. The patient underwent a right occipital craniotomy with complete resection of nidus at the splenium and occlusion of the draining vein from AVM of the middle portion of the corpus callosum, using serial carotid angiography during operation. His postoperative course was uneventful and he was discharged neurologically intact. A carotid angiogram, performed six months later, revealed complete disapperance of the vascular malformation.