Dural arteriovenous malformation causing brainstem haemorrhage

A 40 year old man developed a brainstem haemorrhage from an arteriovenous malformation of the tentorial incisura. Although the location of the haemorrhage represents a unique report, this case illustrates 3 important points that can be generally applied to dural arteriovenous malformations. Firstly, the dangers of dural arteriovenous malformations with cortical venous drainage. Secondly, with regards their risk of haemorrhage, dural arteriovenous malformations (tentorial arteriovenous malformations in particular) cannot be dismissed as benign until angiography has been performed. Finally, angiography performed for the purpose of investigating the possibility of an arteriovenous malformation being responsible for an intraparenchymal haemorrhage cannot be considered truly negative unless the external carotid circulation has failed to demonstrate an arteriovenous malformation in addition to the internal carotid and vertebral circulations.