No abstract

✓ Angiography during the operative procedure is desirable, but is often difficult because of the problem of maintaining a needle or cannula in an artery for long periods of time. Cannulation of the superficial temporal artery avoids this technical problem. The artery is easily found, cannulation is simple, and obliteration of the artery is of no consequence. Cerebral angiography then provides a means for prompt evaluation of the surgical procedure at any time during the actual operation.

Follow-up angiography that no longer shows a cerebral arteriovenous malformation (AVM) after radio surgery is thought to indicate obliteration and protection from risk of hemorrhage. However, angiographically oc cult vascular malformations can bleed, so one might ques tion the degree of protection provided by radiosurgery. The patient reported here was anticoagulated for deep vein thrombosis after a cerebellar AVM had been "oblit erated" by treatment with a gamma knife. He subse quently suffered a fatal supratentorial hemorrhage. At au topsy, no bleeding was seen in the region of the throm bosed AVM. This case is presented as further evidence of the efficacy of radiosurgery in the treatment of cerebral AVMs.