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We report a case of infected subdural hematoma ISH. We followed up an 81 year old man with asymptomatic chronic subdural hematoma CSDH. After half a year, he came to our hospital because of reduced activities of daily living and a high fever. Although his inflammatory markers were high, various cultures and imaging studies yielded negative results. Right hemiparesis developed 5 days later. Burr hole surgery was performed to treat the CSDH. The hematoma proved to be mixed with pus, suggesting ISH. The ISH recurred twice despite antibiotic therapy and repeated irrigation. Finally, inflammatory parameters normalized and computed tomography disclosed an organized CSDH. ISH should be suspected in patients with CSDH presenting with high fever.

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Cerebral vasospasm is a well documented occurrence of aneurysmal subarachnoid hemorrhage but has not been sufficiently analyzed in cases with arteriovenous malformation. Moreover, cerebral vasospasm following arteriovenous malformation rupture is a rare and critical complication. We describe a case of symptomatic cerebral vasospasm following cerebellar arteriovenous malformation rupture.An 8 year old girl presented with deteriorated consciousness. Computed tomography revealed packed intraventricular and diffuse thin subarachnoid hemorrhages due to cerebellar arteriovenous malformation. Immediate endoscopic evacuation of intraventricular hemorrhage was performed. Subsequently, total arteriovenous malformation resection was achieved surgically after preoperative glue embolization. Twelve days posthemorrhage, cerebral angiogram revealed severe vasospasm at both internal carotid arteries. Although emergency intra arterial fasudil hydrochloride injection and balloon angioplasty resolved the vasospasm successfully, postoperative magnetic resonance imaging showed bifrontal cerebral infarction.The characteristic features of cerebral vasospasm after arteriovenous malformation rupture are discussed. In the present case, packed intraventricular hemorrhage could strongly affect significant vasospasm. Treatment of patients with intraventricular hemorrhage related to arteriovenous malformations should consider the risk of severe delayed vasospasm.